| NPI | 1487281325 |
|---|---|
| Former Name | KAYLA HENDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 32292) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 1-172839) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2023-08-31 |