| NPI | 1962828863 |
|---|---|
| Former Name | AMANDA NETTLETON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 225662) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95000159) |
| Enumeration Date | 2014-03-15 |
| Last Update Date | 2022-11-08 |