NPI | 1740838853 |
---|---|
Former Name | KASSIDY FAY BURR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012203) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 277714) |
Enumeration Date | 2019-09-01 |
Last Update Date | 2024-09-13 |