| NPI | 1487170718 |
|---|---|
| Former Name | KELLIE K WAUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G176775) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 104780) |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2023-10-24 |