NPI | 1497434872 |
---|---|
Former Name | KATELYN ALISSA AMMON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 14207-33) |
Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: WI 242068-30) |
Enumeration Date | 2023-07-13 |
Last Update Date | 2023-07-13 |