NPI | 1629361639 |
---|---|
Former Name | KATIE GAYLE SULLIVAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN592667) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN592667) |
163W00000X Registered Nurse (Licence: WI 174761-30) | |
367500000X Nurse Anesthetist, Certified Registered (Licence: MD R162842) | |
Enumeration Date | 2011-05-24 |
Last Update Date | 2021-01-19 |