| NPI | 1790148153 |
|---|---|
| Former Name | KELLY PRATT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 25535) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AZ RN184770) |
| 363LF0000X Nurse Practitioner Family (Licence: GA RN174881) | |
| Enumeration Date | 2016-04-03 |
| Last Update Date | 2023-10-10 |