NPI | 1972878965 |
---|---|
Former Name | CALLIE DEE KITTLESON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: IN 71004842A) |
Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: KY 3007379) |
Enumeration Date | 2012-03-09 |
Last Update Date | 2014-04-29 |