NPI | 1801198239 |
---|---|
Former Name | KATHERINE ELIZABETH AMEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT 124485) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60190270) |
363LF0000X Nurse Practitioner, Family (Licence: VT 101.0076730) | |
Enumeration Date | 2010-11-17 |
Last Update Date | 2021-11-10 |