| NPI | 1588866305 |
|---|---|
| Former Name | MISTY D BOURNE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: KY 3005293) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3005293) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2023-07-21 |