NPI | 1639794084 |
---|---|
Former Name | KIMBERLY RAYE BARKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209021386) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209021386) |
Enumeration Date | 2020-06-11 |
Last Update Date | 2025-01-02 |