NPI | 1578166492 |
---|---|
Former Name | KAREN ANN REARDON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R234785) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1165256) |
Enumeration Date | 2020-11-21 |
Last Update Date | 2022-12-15 |