NPI | 1093118622 |
---|---|
Former Name | KELLY MARIE KAMMER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH COA.16262-NP) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH RX.16262-EX1) |
363LP2300X Nurse Practitioner, Primary Care (Licence: OH RN.338227-COA1) | |
Enumeration Date | 2014-09-26 |
Last Update Date | 2017-02-24 |