| NPI | 1679047146 |
|---|---|
| Former Name | KELLEY PETERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 25362) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 205390) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 25362) | |
| Enumeration Date | 2019-01-17 |
| Last Update Date | 2022-07-13 |