NPI | 1962871202 |
---|---|
Former Name | MICHELLE WONNEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 53-76890-031) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: KS 53-76890-031) |
363LA2200X Nurse Practitioner, Adult Health (Licence: KS 53-76890-031) | |
Enumeration Date | 2015-09-16 |
Last Update Date | 2025-02-03 |