| NPI | 1770046005 |
|---|---|
| Former Name | KELLY ANN LASSITER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: AZ 273617) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: CO APN.0994532-NP) |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2022-04-27 |