| NPI | 1619578218 |
|---|---|
| Former Name | KIMBERLY HANSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.0029947) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OH 461514) |
| Enumeration Date | 2020-11-02 |
| Last Update Date | 2022-04-30 |