| NPI | 1407199011 |
|---|---|
| Former Name | SHERESA BLACKMON MCKITTRICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: SC SC18183) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: SC 18183) |
| 363LF0000X Nurse Practitioner Family (Licence: SC SC18183) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: SC SC18183) | |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2021-10-26 |