| NPI | 1063485514 |
|---|---|
| Former Name | KELLY ANN OVERBAUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN CNP0812) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MN R1121373) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2016-05-03 |