| NPI | 1740714674 |
|---|---|
| Former Name | CHELSEA MARY ROTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3011415) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1137585) |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2024-10-14 |