NPI | 1932218674 |
---|---|
Former Name | KRISTINE MARIE KELLERHOUSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 089006990N7) |
Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: OR 089006990N7) |
Enumeration Date | 2006-08-29 |
Last Update Date | 2008-03-05 |