| NPI | 1235957275 |
|---|---|
| Former Name | KELLIE ANTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MO 2024069221) |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2025-07-05 |