| NPI | 1730767302 |
|---|---|
| Former Name | KRISTEN ELAINE KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MD R209202) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MD RN706137) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP023459) | |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2024-05-14 |