| NPI | 1548780729 |
|---|---|
| Former Name | KAYLA M FISK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 0000025756) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0993147-NP) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2022-01-27 |