| NPI | 1497220511 |
|---|---|
| Former Name | BRANDY ZELL MCKIBBIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024184579) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP138965) |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2023-12-13 |