NPI | 1356775670 |
---|---|
Former Name | KATHRYN CELESTE BENNETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704260207) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704260207) |
Enumeration Date | 2013-08-22 |
Last Update Date | 2018-12-04 |