| NPI | 1376191312 | 
|---|---|
| Former Name | KATHLEEN KAYE DEVERA | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1021237) | 
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: OR 201709498RN) | 
| Enumeration Date | 2019-09-03 | 
| Last Update Date | 2022-01-24 |