| NPI | 1124779129 |
|---|---|
| Former Name | KELLIE DANIELLE DICKEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 216046) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 25717) |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2024-09-03 |