NPI | 1376855114 |
---|---|
Former Name | KELLEY ELIZABETH SICLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 405689) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: NY 430505) |
163W00000X Registered Nurse (Licence: NY 517355) | |
Enumeration Date | 2010-07-09 |
Last Update Date | 2024-08-02 |