| NPI | 1437533288 |
|---|---|
| Former Name | KELLY THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 262812) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP128485) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2023-07-25 |