| NPI | 1801174313 |
|---|---|
| Former Name | KRISTA LYNN ELLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: ID NP-1085A) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: WA AP 60282458) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2015-11-21 |