NPI | 1194357749 |
---|---|
Former Name | KRISTEN SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 7964749-4409) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: UT 7964749-3102) |
Enumeration Date | 2020-02-11 |
Last Update Date | 2020-04-08 |