NPI | 1649514316 |
---|---|
Former Name | KELLY KATHLEEN FORSTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 277001068) |
Additional Taxonomies | 163WX0003X Registered Nurse, Obstetric, Inpatient (Licence: IL 041369474) |
367A00000X Advanced Practice Midwife (Licence: IL 209009824) | |
Enumeration Date | 2012-11-19 |
Last Update Date | 2023-05-08 |