| NPI | 1225471717 |
|---|---|
| Former Name | KALLIE FOGLESONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012010424) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MO 2012010424) |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2023-11-06 |