| NPI | 1285187542 |
|---|---|
| Former Name | KELLY EASTHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.019496) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010659) |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2021-03-23 |