| NPI | 1528600350 |
|---|---|
| Former Name | CAITLIN AMANDA ELLISON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OK 113882) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK 113882) |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2024-03-27 |