| NPI | 1124891858 |
|---|---|
| Former Name | KATIE ANN LONGENECKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 11177) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ND 204623) |
| Enumeration Date | 2023-11-03 |
| Last Update Date | 2026-05-29 |