| NPI | 1013386960 |
|---|---|
| Former Name | KELLY AMANDA TIPTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 23844) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2008011702) |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2023-12-27 |