| NPI | 1710565510 |
|---|---|
| Former Name | KATE ELIZABETH KALLEVIG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 041557167) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 905407) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 29263) | |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2024-01-03 |