| NPI | 1134894421 |
|---|---|
| Former Name | KATHRYN ELISABETH SPARKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024182132) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 30128) |
| Enumeration Date | 2021-08-10 |
| Last Update Date | 2021-08-10 |