NPI | 1275003394 |
---|---|
Former Name | KIMBERLY REIGLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 8726-33) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 8726-33) |
363LF0000X Nurse Practitioner, Family (Licence: IL 209.020547) | |
Enumeration Date | 2018-12-01 |
Last Update Date | 2023-07-06 |