NPI | 1508535063 |
---|---|
Former Name | KATIE JO MANN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0999197) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN.1692767) |
163W00000X Registered Nurse (Licence: TN 240683) | |
363LF0000X Nurse Practitioner, Family (Licence: TN 30293) | |
Enumeration Date | 2021-09-08 |
Last Update Date | 2024-09-16 |