NPI | 1649920752 |
---|---|
Former Name | CAITLIN MCKENNA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209025049) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209-025049) |
Enumeration Date | 2022-03-24 |
Last Update Date | 2025-02-04 |