NPI | 1144767344 |
---|---|
Former Name | KELLY D KASTING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71007550A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28209377A) |
Enumeration Date | 2017-01-25 |
Last Update Date | 2023-08-16 |