| NPI | 1063901577 |
|---|---|
| Former Name | KELLY MODES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP018764) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP018764) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2021-09-21 |