| NPI | 1245548486 |
|---|---|
| Former Name | BOBBI KAYE PORTWOOD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2324031) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2010029875) |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2020-12-15 |