| NPI | 1013288448 |
|---|---|
| Former Name | KELLY MAE MCCARTHY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 28176558A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71003885A) |
| Enumeration Date | 2012-01-17 |
| Last Update Date | 2018-03-07 |