NPI | 1952800195 |
---|---|
Former Name | KYLA LEE ANDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012047) |
Additional Taxonomies | 364SF0001X Clinical Nurse Specialist, Family Health (Licence: KY 3012047) |
Enumeration Date | 2018-02-02 |
Last Update Date | 2022-02-15 |