NPI | 1972853208 |
---|---|
Former Name | SHANNON SLAGTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN CNP3193) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN R1789773) |
Enumeration Date | 2012-09-13 |
Last Update Date | 2023-03-27 |