NPI | 1073265070 |
---|---|
Former Name | KAITLIN RAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 11723) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI F01220262) |
163W00000X Registered Nurse (Licence: WI 236372) | |
Enumeration Date | 2022-01-20 |
Last Update Date | 2025-09-15 |