| NPI | 1760897813 |
|---|---|
| Former Name | KAYLA GULLICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R33462) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ND R33462) |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2015-12-26 |