| NPI | 1710537675 |
|---|---|
| Former Name | KAITLYN FLOURNOY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2548) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003144A) |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2025-04-03 |