| 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 |