| NPI | 1245808526 |
|---|---|
| Former Name | KATHLENE REBECCA SUKUP AND SIEVERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 113602) |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2021-06-14 |