| NPI | 1679951636 |
|---|---|
| Former Name | KRISTA ANKLAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 164566) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 6400) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2021-01-20 |