| NPI | 1457944704 |
|---|---|
| Former Name | KIMBERLY RENEE RUNNELLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0028427) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH LE-00035311) |
| 363L00000X Nurse Practitioner (Licence: CT 10228) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71011194A) | |
| Enumeration Date | 2021-02-18 |
| Last Update Date | 2024-01-05 |