NPI | 1053947549 |
---|---|
Former Name | MARY KATHERINE ISMERT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MO 2019038327) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019038328) |
363LA2100X Nurse Practitioner, Acute Care (Licence: KS 5378984012) | |
363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2019038327) | |
Enumeration Date | 2020-03-17 |
Last Update Date | 2024-01-05 |