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 | 2024-10-22 |