NPI | 1922680461 |
---|---|
Former Name | KYLEIGH BAKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 2022064087) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-181994) |
Enumeration Date | 2021-04-23 |
Last Update Date | 2022-12-19 |