| NPI | 1972218998 | 
|---|---|
| Former Name | KATELYN RAE BIGGERSTAFF | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5381) | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical | 
| Enumeration Date | 2023-01-16 | 
| Last Update Date | 2024-06-17 |