| NPI | 1205189321 |
|---|---|
| Former Name | NELLIE KIPPLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11246) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1832) |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2015-08-25 |