| NPI | 1679995658 |
|---|---|
| Former Name | KIMBERLY RAE POLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: OH 15349-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 353026-RN) |
| Enumeration Date | 2014-01-10 |
| Last Update Date | 2020-12-28 |