NPI | 1649685546 |
---|---|
Former Name | KATIE JO RUDNITSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 195420-7) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 195420-7) |
Enumeration Date | 2014-06-30 |
Last Update Date | 2021-03-11 |