| NPI | 1124533872 |
|---|---|
| Former Name | KATIE JEAN ERICHSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024180442) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60804361) |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2022-06-09 |