NPI | 1629630165 |
---|---|
Former Name | KIMBERLY NE'SHA HANKSTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163WP2201X Registered Nurse, Ambulatory Care (Licence: MA RN10009394) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MA LN97069) |
Enumeration Date | 2019-07-04 |
Last Update Date | 2024-08-21 |