NPI | 1780145672 |
---|---|
Former Name | CAITLIN RICHELLE MENSIE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-166720) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-166720) |
Enumeration Date | 2019-03-25 |
Last Update Date | 2023-07-30 |