NPI | 1639573421 |
---|---|
Former Name | KIMBERLY A BRADHAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: ME CNP211108) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: VA 0024172127) |
363LA2100X Nurse Practitioner, Acute Care (Licence: ME CNP211108) | |
363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024172127) | |
363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024172127) | |
Enumeration Date | 2014-10-22 |
Last Update Date | 2023-05-15 |