NPI | 1609547488 |
---|---|
Former Name | KRISTEN DIRKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 54159) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP61226691) |
Enumeration Date | 2021-09-22 |
Last Update Date | 2024-05-28 |