| NPI | 1053076315 |
|---|---|
| Former Name | KAYLENE LYNN O'ROURKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R180632) |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2021-11-02 |