NPI | 1912454455 |
---|---|
Former Name | KATELYN C SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704373177) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5008868) |
363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: IN 71013513A) | |
Enumeration Date | 2016-09-01 |
Last Update Date | 2023-01-25 |