| 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 | 2020-04-23 |