NPI | 1588132096 |
---|---|
Former Name | KRISTINA MARIE REYNOLDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: AZ 218593) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 218593) |
363LG0600X Nurse Practitioner, Gerontology (Licence: AZ 218593) | |
Enumeration Date | 2018-11-02 |
Last Update Date | 2024-12-13 |