NPI | 1396492922 |
---|---|
Former Name | KATHRYN JEAN MYROLD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 4004535) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704294787NSA230DC) |
Enumeration Date | 2022-03-03 |
Last Update Date | 2023-11-03 |