| NPI | 1649779760 |
|---|---|
| Former Name | KRISTEN ELIZABETH DAVENPORT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN APN0000023636) |
| Enumeration Date | 2018-02-04 |
| Last Update Date | 2018-02-04 |