| NPI | 1316507205 |
|---|---|
| Former Name | BETH DARGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 78863) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 78863) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS F06190102) | |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2021-09-03 |