| NPI | 1154893998 |
|---|---|
| Former Name | KELLY DANIELLE VANOVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 25282) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024177474) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TN 182525) | |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2023-12-12 |