| NPI | 1154810612 |
|---|---|
| Former Name | PAIGE KIMBROUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR A005666) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AR R098054) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2018-06-06 |