NPI | 1760496814 |
---|---|
Former Name | KATHRYN KELLY SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN182759) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013003462) |
Enumeration Date | 2006-07-27 |
Last Update Date | 2013-05-15 |