NPI | 1962887109 |
---|---|
Former Name | KELCI BROOKE BURNS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-76507-042) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2014035979) |
Enumeration Date | 2015-07-29 |
Last Update Date | 2015-07-29 |