| NPI | 1609416171 |
|---|---|
| Former Name | KATIE A LANGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71012484A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704313736) |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2023-12-03 |