| NPI | 1861762783 |
|---|---|
| Former Name | KATHRYN MARIE HEIDORN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000016365) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 16365) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP144118) | |
| Enumeration Date | 2012-01-09 |
| Last Update Date | 2021-04-06 |