NPI | 1538750690 |
---|---|
Former Name | KELSEY R PRIMROSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209022554) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.022554) |
Enumeration Date | 2021-02-01 |
Last Update Date | 2023-04-04 |