NPI | 1750087482 |
---|---|
Former Name | KRISTIN ALYSSA KELLY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2287703) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2287703) |
Enumeration Date | 2023-02-03 |
Last Update Date | 2023-12-08 |