NPI | 1700221801 |
---|---|
Former Name | KAELA RAE FIELDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN277074) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704295204) |
Enumeration Date | 2013-05-02 |
Last Update Date | 2018-11-19 |