| NPI | 1487063897 |
|---|---|
| Former Name | KELLY M JANK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PA-567) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AR PA-567) |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2022-09-29 |