NPI | 1861825135 |
---|---|
Former Name | KIMBERLY ROSE HORACEK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 111455) |
Additional Taxonomies | 363LW0102X Nurse Practitioner Women's Health (Licence: IA F134833) |
363LW0102X Nurse Practitioner Women's Health (Licence: NE 111455) | |
Enumeration Date | 2013-08-09 |
Last Update Date | 2023-07-17 |