| NPI | 1578007746 |
|---|---|
| Former Name | KIMBERLY BLAKE MATTHEWS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00691200) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NR18011900) |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2020-02-18 |