| NPI | 1649719915 |
|---|---|
| Former Name | KELLY GILLIAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704272053) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5018989) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209028496) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ 303204) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CO CAPN.0101629) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 0033314) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN9482729) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1102491) | |
| Enumeration Date | 2017-02-19 |
| Last Update Date | 2024-05-16 |