| NPI | 1952851784 |
|---|---|
| Former Name | KATELYN MICHELLE CAMPBELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024175199) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 23079) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: AL 1-130379) | |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2022-10-24 |