| NPI | 1578870069 |
|---|---|
| Former Name | KIMBERLY SUE TULL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201393029NP-PP) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA NP19924) |
| 208000000X Pediatrics (Licence: CA NP19924) | |
| 363L00000X Nurse Practitioner (Licence: CA NP19924) | |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2021-03-25 |