NPI | 1932618113 |
---|---|
Former Name | ERICA ANNE PETERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 8864117-4405) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 8864117-3102) |
363L00000X Nurse Practitioner (Licence: UT 8864117-4405) | |
Enumeration Date | 2017-09-20 |
Last Update Date | 2024-04-22 |