| NPI | 1316702806 |
|---|---|
| Former Name | KATHERINE R PRUSSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 10395769-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 10395769-3102) |
| Enumeration Date | 2024-02-14 |
| Last Update Date | 2025-01-29 |