NPI | 1124526611 |
---|---|
Former Name | KATHLEEN M LEDBETTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014365) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 28173158A) |
Enumeration Date | 2018-01-30 |
Last Update Date | 2020-04-22 |