| NPI | 1699170019 |
|---|---|
| Former Name | KIMBERLY NICOLE STEPHENS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 19303) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 19303) |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2024-02-22 |