| NPI | 1558762476 |
|---|---|
| Former Name | KENLYN MARIE FARLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704266783) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71009215A) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2021-05-17 |