| NPI | 1023086972 |
|---|---|
| Former Name | KIMBERLY MICHELLE BOAZE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 960056) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 121777) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 960056) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2024-01-22 |