| NPI | 1023797313 |
|---|---|
| Former Name | KELLIE SUE SKIRVIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner Women's Health (Licence: TX 1131096) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 705982) |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2023-08-10 |