NPI | 1558695783 |
---|---|
Former Name | KELLY WELCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP111042) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: ME RN62266) |
Enumeration Date | 2009-09-21 |
Last Update Date | 2014-04-08 |