| NPI | 1013360940 |
|---|---|
| Former Name | KELLYN PATRICIA FREED |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 24176021) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 068318-23) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176021) | |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2020-11-19 |