| NPI | 1821403445 |
|---|---|
| Former Name | KENDALL MICHELLE DAVERN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 18828) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 18828) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2017-07-12 |