| NPI | 1366109498 |
|---|---|
| Former Name | KELLY MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH APRN.CNP.0030319) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH CNP.0030319) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: OH APRN.CNP.0030319) | |
| Enumeration Date | 2021-11-23 |
| Last Update Date | 2023-04-26 |