NPI | 1831723360 |
---|---|
Former Name | MELISSA ANNE KIMBALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0995395-NP) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN.1630481) |
Enumeration Date | 2020-02-24 |
Last Update Date | 2022-06-08 |