| NPI | 1952940207 |
|---|---|
| Former Name | KELLY N GILLENWATER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0001198100) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001198100) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 007058) | |
| Enumeration Date | 2020-01-04 |
| Last Update Date | 2023-01-06 |