| NPI | 1811361868 |
|---|---|
| Former Name | KATIE DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209013501) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209013501) |
| Enumeration Date | 2015-11-13 |
| Last Update Date | 2024-04-08 |