| NPI | 1376670570 | 
|---|---|
| Former Name | KALA NICOLE PHILLIPS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R865872)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS R865872)  | 
| Enumeration Date | 2007-02-27 | 
| Last Update Date | 2021-05-24 |