| NPI | 1215606900 |
|---|---|
| Former Name | LAURYN ALISSA KENNEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP024293) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP024293) |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2022-03-15 |