| NPI | 1356647655 |
|---|---|
| Former Name | KELLY MARIE RANKIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 198216) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9236602) |
| Enumeration Date | 2011-02-03 |
| Last Update Date | 2015-02-18 |