NPI | 1124661707 |
---|---|
Former Name | KRISTEN TRIMBLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 254416) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 077960-23) |
Enumeration Date | 2019-10-25 |
Last Update Date | 2022-11-08 |