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 |