| NPI | 1003881996 |
|---|---|
| Former Name | JEANNINE SUSAN CONRADE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist Psychiatric/Mental Health (Licence: KS 74510) |
| Additional Taxonomies | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: KS 1346573022) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2007-07-08 |