| NPI | 1194298448 |
|---|---|
| Former Name | KELLY CHRISTINA DONALDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024180381) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN0000205462) |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2023-04-16 |