| NPI | 1699552422 |
|---|---|
| Former Name | KATHERINE J NICKDOW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: VA 0024188286) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2023-09-14 |
| Last Update Date | 2023-11-28 |