NPI | 1568854115 |
---|---|
Former Name | KIM CONWAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP08208) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: LA AP08208) |
Enumeration Date | 2015-02-19 |
Last Update Date | 2023-10-23 |