Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | AP60249010 | WA |
N | 363LA2100X | Nurse Practitioner - Acute Care | AP60249010 | WA |
N | 363LA2200X | Nurse Practitioner - Adult Health | AP60249010 | WA |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | AP60249010 | WA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP60249010 | WA |
N | 363LG0600X | Nurse Practitioner - Gerontology | AP60249010 | WA |
N | 363LP2300X | Nurse Practitioner - Primary Care | AP60249010 | WA |
NPI | 1588948954 |
---|---|
Provider Name | Kilea Linnet Mudaliar |
First Address | Tacoma, WA 98407-1368 |
Second Address | Minnetonka, MN 55343-9664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2011 |
Last Update Date | 29/06/2020 |