| NPI | 1578961520 | 
|---|---|
| Former Name | KATIE JENKINS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.021355)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 19471)  | 
| Enumeration Date | 2014-12-08 | 
| Last Update Date | 2021-03-04 |