| NPI | 1619513611 |
|---|---|
| Former Name | KRISTA MCKINNEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CA 95012088) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95012088) |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2023-10-25 |