| NPI | 1558804971 |
|---|---|
| Former Name | KACIE MIRANDA MINTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN230749) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: GA RN230749) |
| Enumeration Date | 2016-12-02 |
| Last Update Date | 2017-04-12 |