NPI | 1144521022 |
---|---|
Former Name | TARA M. KERNS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024187060) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2011013790) |
363L00000X Nurse Practitioner (Licence: KS 53-75230-101) | |
Enumeration Date | 2010-11-09 |
Last Update Date | 2024-03-27 |