NPI | 1659618163 |
---|---|
Former Name | KELLY ANN KAIGHN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE L1-0039390) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: DE LG0000640) |
Enumeration Date | 2013-01-04 |
Last Update Date | 2019-09-04 |