NPI | 1902397631 |
---|---|
Former Name | KRISTEN SPAIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 2321770) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2321770) |
Enumeration Date | 2018-05-29 |
Last Update Date | 2024-09-26 |