NPI | 1467827592 |
---|---|
Former Name | KELLY AUGSBURGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-013789) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041-370455) |
Enumeration Date | 2015-12-01 |
Last Update Date | 2018-03-05 |