| NPI | 1235764374 |
|---|---|
| Former Name | KELLY JEAN MARTINEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CO APN.0996244-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 0161722) |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2021-02-11 |