| NPI | 1215650478 |
|---|---|
| Former Name | MAKENZIE TETER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209026366) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: IN 28277211A) |
| 363L00000X Nurse Practitioner (Licence: IN 71013157A) | |
| Enumeration Date | 2022-09-22 |
| Last Update Date | 2024-02-28 |