NPI | 1487644712 |
---|---|
Former Name | KELLI MEREDITH MAY DAVIDSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 03722) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA 075341) |
Enumeration Date | 2005-10-27 |
Last Update Date | 2016-09-02 |