| NPI | 1811258213 |
|---|---|
| Former Name | KIMBERLY AMANDA WALDROP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 15676) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000015676) |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2017-02-23 |