| NPI | 1184190613 |
|---|---|
| Former Name | SHELBY KOEHL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.018341) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.411087) |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2018-10-23 |