NPI | 1801036041 |
---|---|
Former Name | KELLY JEAN GRAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: WA RN60076144) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WA LP00059279) |
Enumeration Date | 2009-02-28 |
Last Update Date | 2009-02-28 |