| NPI | 1962273037 |
|---|---|
| Former Name | DANIELLE MORTENSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209028862) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209028862) |
| Enumeration Date | 2024-01-09 |
| Last Update Date | 2026-04-30 |