NPI | 1740735844 |
---|---|
Former Name | KATIE LYNN CONLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017025483) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ AP8859) |
363L00000X Nurse Practitioner (Licence: AZ AP8859) | |
363LF0000X Nurse Practitioner, Family (Licence: AZ AP8859) | |
Enumeration Date | 2016-08-18 |
Last Update Date | 2019-06-11 |