NPI | 1063584209 |
---|---|
Former Name | KIMBERLY ANN PHILLIPS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3006789) |
Enumeration Date | 2006-11-14 |
Last Update Date | 2016-01-29 |