| NPI | 1144956509 | 
|---|---|
| Former Name | MCKENZIE BEAR | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0031846)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 0031846)  | 
| Enumeration Date | 2022-07-28 | 
| Last Update Date | 2024-06-12 |