| NPI | 1962870790 |
|---|---|
| Former Name | HEATHER RENEE GRUNDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AK 217706) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.013001) |
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: IL 209.013001) | |
| Enumeration Date | 2015-09-10 |
| Last Update Date | 2024-02-06 |