| NPI | 1215271994 |
|---|---|
| Former Name | KELLY A WASZAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5165) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: WI 154594) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2022-05-25 |