| NPI | 1639113616 |
|---|---|
| Former Name | KELLI ANNE DAVIDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30007170) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN00156248) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2021-05-03 |