| NPI | 1942685151 |
|---|---|
| Former Name | ELESA L FETTERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CO 0993073) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 92861) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2021-08-13 |