| NPI | 1922441625 |
|---|---|
| Former Name | KYLEE CAROLINE BOHANNON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP 60343539) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 202109850NP-PP) |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2023-02-02 |