NPI | 1740835164 |
---|---|
Former Name | KIMBERLY KAY BURRESS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 4007045) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 28134347A) |
Enumeration Date | 2019-08-02 |
Last Update Date | 2023-10-13 |