| NPI | 1144558404 |
|---|---|
| Former Name | KIMBERLY ANNE TYRA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: GA RN119081) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: GA RN119081CNS/PMH) |
| Enumeration Date | 2009-11-25 |
| Last Update Date | 2024-02-20 |