NPI | 1871050492 |
---|---|
Former Name | KAITLYN RENEE CROCKETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11033202) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN272235) |
Enumeration Date | 2019-03-01 |
Last Update Date | 2024-09-10 |