| NPI | 1720694094 |
|---|---|
| Former Name | KATELYNN DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: IL 209022044) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: IL 209.022044) |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2025-09-22 |