Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 105618 | OK |
NPI | 1003358359 |
---|---|
Provider Name | Catherine Marie Kindt |
First Address | Edmond, OK 73034-2160 |
Second Address | Edmond, OK 73034-2160 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2016 |
Last Update Date | 25/02/2017 |