NPI | 1659827152 |
---|---|
Former Name | KELLY MARIE BROTHERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH APRN.CNP.019408) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH APRN.CNP.019408) |
Enumeration Date | 2016-08-25 |
Last Update Date | 2022-02-25 |