| NPI | 1588611859 |
|---|---|
| Former Name | KELLY M SMALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.021578) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2001017746) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2022-05-20 |