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Individual
KRISTIE LEE BRACKETT
Active
Individual
KRISTIE LEE BRACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
71011639A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
71011639A
IN
Other
Enumeration date
10/12/2021
Last updated
06/01/2022
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