| NPI | 1497201107 |
|---|---|
| Former Name | CASEY JEAN CLARDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 7170-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 189789) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2021-12-07 |