NPI | 1982655478 |
---|---|
Former Name | KACIE D HARTWICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2004002306) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 45649) |
Enumeration Date | 2006-05-12 |
Last Update Date | 2015-07-23 |