NPI | 1093183642 |
---|---|
Former Name | KELLY MARIE NAVARRE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NC 162782) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 162782) |
Enumeration Date | 2015-09-11 |
Last Update Date | 2015-09-29 |