NPI | 1306485636 |
---|---|
Former Name | KATIE BURLEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704336083) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 4704336083) |
163W00000X Registered Nurse (Licence: OH 406155) | |
Enumeration Date | 2020-01-03 |
Last Update Date | 2022-05-20 |