| NPI | 1780247247 |
|---|---|
| Former Name | MISTY MCGILL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018043983) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-78549-072) |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2019-09-17 |