NPI | 1689223869 |
---|---|
Former Name | AMY ROSEMARIE KENNING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2019026965) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019026965) |
Enumeration Date | 2019-09-10 |
Last Update Date | 2024-09-13 |