| NPI | 1023531126 |
|---|---|
| Former Name | KIRSTEN EMILY WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201807434NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201403790RN) |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2019-09-20 |