| NPI | 1679197982 | 
|---|---|
| Former Name | KRISTIN WHITE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202004201NP-PP) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 202004201NP) | 
| Enumeration Date | 2020-06-02 | 
| Last Update Date | 2020-06-02 |