NPI | 1629668462 |
---|---|
Former Name | KELLY JOHANNA HUNEKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 7905) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 7905) |
Enumeration Date | 2021-01-26 |
Last Update Date | 2024-01-17 |