| NPI | 1013698802 |
|---|---|
| Former Name | KIMBERLY ANN FUSILLI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 432806) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 686481) |
| Enumeration Date | 2023-07-26 |
| Last Update Date | 2023-11-05 |