NPI | 1912607508 |
---|---|
Former Name | BAILEY BROOKE WARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82110-042) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS F02230732) |
Enumeration Date | 2023-03-03 |
Last Update Date | 2024-07-10 |