NPI | 1982294450 |
---|---|
Former Name | KARA MARIE SANDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 11908) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MN 2245698) |
Enumeration Date | 2021-01-19 |
Last Update Date | 2024-08-07 |