| NPI | 1366980302 |
|---|---|
| Former Name | KRISTIN FARRELL WENSLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN2262692) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MA RN2262692) |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2017-09-28 |