NPI | 1982943452 |
---|---|
Former Name | KIMBERLY NICOLE CROUSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN245855) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R196074) |
Enumeration Date | 2013-02-04 |
Last Update Date | 2015-04-03 |