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 |