| NPI | 1558728626 |
|---|---|
| Former Name | KATELYN DANIELLE CRESSWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3274) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: VA 0110006145) | |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2024-02-26 |