| NPI | 1194007955 |
|---|---|
| Former Name | KATHY MARIE THEISSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61592288) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN00097770) |
| 163WC1500X Registered Nurse, Community Health (Licence: WA 00097770) | |
| Enumeration Date | 2011-09-16 |
| Last Update Date | 2024-09-30 |