| NPI | 1215695747 |
|---|---|
| Former Name | NICOLE KRISTIN KINNAMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71011704A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28178442A) |
| Enumeration Date | 2021-12-01 |
| Last Update Date | 2022-04-26 |