NPI | 1598142028 |
---|---|
Former Name | KRISTIN D CLEAVINGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015005065) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2015005065) |
Enumeration Date | 2015-05-05 |
Last Update Date | 2022-04-03 |