| NPI | 1225314560 |
|---|---|
| Former Name | KATHLEEN MARIE EARNEST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC APN19005) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209009043) |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2015-02-06 |