| NPI | 1093579484 |
|---|---|
| Former Name | KATELYNN WEATHERLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 78974) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: ID 50320) |
| Enumeration Date | 2024-02-07 |
| Last Update Date | 2024-03-28 |