NPI | 1952676421 |
---|---|
Former Name | AMY LYN VANDENBERG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MN 3845) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: WI 144155-30) |
163W00000X Registered Nurse (Licence: MN R225959-0) | |
163WM0705X Registered Nurse, Medical-Surgical (Licence: WI 144155-30) | |
363LA2100X Nurse Practitioner, Acute Care (Licence: WI 4962-33) | |
Enumeration Date | 2012-03-17 |
Last Update Date | 2022-04-08 |