| NPI | 1073654281 |
|---|---|
| Former Name | KIMBERLY MARIE SHULL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP2961192) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP2961192) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5007884) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN2961192) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2020-10-21 |