| NPI | 1154671071 |
|---|---|
| Former Name | ALISA COLLEEN KEARNEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209018421) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 21250) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2018-12-28 |