NPI | 1174128706 |
---|---|
Former Name | KELLI BEARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP001344) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11022261) |
Enumeration Date | 2020-12-02 |
Last Update Date | 2024-05-29 |