| NPI | 1831599018 |
|---|---|
| Former Name | KRISTEN MARIE ELLISOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP125804) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP125804) |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2023-07-05 |