| NPI | 1417147463 |
|---|---|
| Former Name | KIMBERLY LAYCINTHIA STEWART |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9166317) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL 9166317) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2021-09-13 |