| NPI | 1619540770 |
|---|---|
| Former Name | KIMBERLY RAE PETERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 070084-23) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NH 070084-21) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2295854) | |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2023-06-23 |