NPI | 1962057166 |
---|---|
Professional Name | KIMMI JEAN HANNERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 11022) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT 141908) |
363A00000X Physician Assistant (Licence: PA MA062451) | |
Enumeration Date | 2019-08-05 |
Last Update Date | 2025-04-10 |