NPI | 1720429095 |
---|---|
Former Name | KIMBERLY ANN MONTGOMERY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95011334) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH COA.14778-NP) |
Enumeration Date | 2013-07-15 |
Last Update Date | 2019-03-15 |