NPI | 1740800788 |
---|---|
Former Name | KAYLA J BROCKWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4020267) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1081653) |
363LA2100X Nurse Practitioner, Acute Care (Licence: IN 71009988A) | |
363LF0000X Nurse Practitioner, Family (Licence: IN 71009988A) | |
Enumeration Date | 2020-04-20 |
Last Update Date | 2024-10-16 |