NPI | 1720104102 |
---|---|
Former Name | KELLY WRISTEN WEST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN150994) |
Enumeration Date | 2007-03-21 |
Last Update Date | 2025-08-04 |