NPI | 1811793946 |
---|---|
Former Name | KENDRA JO AUSMUS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2024045263) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2007018601) |
163W00000X Registered Nurse (Licence: IL 041509652) | |
Enumeration Date | 2025-02-20 |
Last Update Date | 2025-02-20 |