| NPI | 1346734720 | 
|---|---|
| Former Name | KATELYN DIANA ANDERSON | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 23934)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP002185)  | 
| Enumeration Date | 2018-06-19 | 
| Last Update Date | 2024-06-05 |