| NPI | 1669154670 |
|---|---|
| Former Name | KATELYN MITCHELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.028163) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.436332) |
| Enumeration Date | 2023-08-01 |
| Last Update Date | 2024-03-15 |