| NPI | 1871092478 |
|---|---|
| Former Name | KATHRYN GRACE DOUGLASS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 23856) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 195489) |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2023-03-25 |