| NPI | 1700262722 |
|---|---|
| Former Name | KATELYN NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704276417) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704276417) |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2018-12-04 |