NPI | 1407313729 |
---|---|
Former Name | KELLY LYNN HANN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5018023) |
Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NC 5018023) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024177340) | |
Enumeration Date | 2019-02-22 |
Last Update Date | 2024-08-22 |