| NPI | 1093185936 |
|---|---|
| Former Name | KATHLEEN SARAH NICHOLSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AZ LP043776) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AL 2-070401) |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2019-06-06 |