NPI | 1023688397 |
---|---|
Former Name | KERRY LYNN WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: PA SP025871) |
Additional Taxonomies | 163WM0102X Registered Nurse, Maternal Newborn (Licence: PA RN703274) |
Enumeration Date | 2021-06-29 |
Last Update Date | 2022-07-28 |