| NPI | 1710459706 |
|---|---|
| Former Name | KAITLYNN PUCKETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: TN 26158) |
| Enumeration Date | 2019-01-02 |
| Last Update Date | 2020-06-03 |