NPI | 1699320705 |
---|---|
Former Name | KELLY CEPHAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.025223) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.325437) |
Enumeration Date | 2019-08-06 |
Last Update Date | 2025-10-10 |