NPI | 1578748810 |
---|---|
Former Name | KATHY MARIE O'CONNELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 12762) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN APN0000012762) |
Enumeration Date | 2008-01-06 |
Last Update Date | 2018-03-24 |