| NPI | 1407042468 |
|---|---|
| Former Name | KRISTEN LEBEAU BURGESS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH 318939) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: OH 318939) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2011-06-09 |