NPI | 1821388836 |
---|---|
Former Name | KELLY JENA MILLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN187026) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN187026) |
363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN187026) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN187026) | |
Enumeration Date | 2011-04-11 |
Last Update Date | 2021-11-30 |