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 |