| NPI | 1619693033 |
|---|---|
| Former Name | KELLY ANDREA CIESLAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 13213) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 13213) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: WI 13213) | |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2024-05-29 |