| NPI | 1932741683 |
|---|---|
| Former Name | KATIE ELIZABETH DEINES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP002763) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9470219) |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2025-01-01 |