| NPI | 1205235355 |
|---|---|
| Former Name | KIMBERLY L. KOEHNE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023006444) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209011642) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2023-06-21 |