| NPI | 1306975909 |
|---|---|
| Former Name | COLLEEN STEPHENS-KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP115002) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 257249) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2021-08-10 |