| NPI | 1578919668 |
|---|---|
| Former Name | KRISTY D KOEBERL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2015016097) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 153988) |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2016-05-09 |