| NPI | 1346355542 |
|---|---|
| Former Name | KIM TRACY NAUTA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 1544-033) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 80028-030) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2021-12-01 |