| NPI | 1255840401 |
|---|---|
| Former Name | KIMBERLY ANNE HEYSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71007536A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71007536A) |
| 163W00000X Registered Nurse (Licence: IN 28199185A) | |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2022-07-21 |