| NPI | 1134608094 |
|---|---|
| Former Name | KELLY KATHLEEN MCNEIL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN236326) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN236326) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN236326) | |
| Enumeration Date | 2018-08-11 |
| Last Update Date | 2020-03-18 |