| NPI | 1114580271 |
|---|---|
| Former Name | KATELYN JOY KOSTREVA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO APN.0994622-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO F03190591) |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2024-02-15 |