| NPI | 1336534064 |
|---|---|
| Former Name | KELSEY CANNON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 894538) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP127701) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2018-09-28 |