| NPI | 1457767345 |
|---|---|
| Former Name | KACEY Q. ROACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 18815) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 182891) |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2022-01-21 |