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 | 2024-11-06 |