NPI | 1104070457 |
---|---|
Former Name | KELLI NICHOLE PASTRICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN164623) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA 164623) |
Enumeration Date | 2008-11-13 |
Last Update Date | 2022-10-05 |