| NPI | 1730320623 |
|---|---|
| Former Name | KAY LYNN SOUTHERN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP8742) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704216251) |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2024-09-30 |