| NPI | 1467883769 |
|---|---|
| Former Name | KATHERINE RENEE HEYDE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10173) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: TX PA08835) |
| 363A00000X Physician Assistant | |
| 363A00000X Physician Assistant (Licence: TX PA08835) | |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2021-05-19 |