| NPI | 1376150052 |
|---|---|
| Former Name | KIMBERLY MARIE WHITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1108758) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 786176) |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2025-01-10 |