NPI | 1356807028 |
---|---|
Former Name | KATHRYN JO BRADSHAW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 024265) |
Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: OH 340095) |
Enumeration Date | 2019-02-18 |
Last Update Date | 2021-09-13 |