NPI | 1881118685 |
---|---|
Former Name | KELLY RIELY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 1699032) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DC RN1061175) |
363LF0000X Nurse Practitioner, Family (Licence: VA 0024175328) | |
Enumeration Date | 2017-08-02 |
Last Update Date | 2024-10-24 |