NPI | 1609173434 |
---|---|
Former Name | KELLIE J MEYER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: IL 041335792) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209008646) |
Enumeration Date | 2011-02-14 |
Last Update Date | 2011-02-14 |