NPI | 1144485996 |
---|---|
Former Name | KRISTI LEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 041339447) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209007327) |
363L00000X Nurse Practitioner (Licence: MO 2013010825) | |
Enumeration Date | 2008-07-22 |
Last Update Date | 2018-12-12 |