NPI | 1497908529 |
---|---|
Former Name | AMY MICHELLE KENNEDY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-077902) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-077902) |
Enumeration Date | 2008-11-03 |
Last Update Date | 2021-11-17 |