NPI | 1710483771 |
---|---|
Former Name | KELLY J CRAGETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN9212525) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN9212525) |
Enumeration Date | 2018-03-30 |
Last Update Date | 2025-04-16 |