| NPI | 1568544401 |
|---|---|
| Former Name | KELLIE M. O'HARA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 339604) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP7772) |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP60755079) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2300400) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2023-02-07 |