| NPI | 1013569722 |
|---|---|
| Former Name | JESSICA JO SHAFER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 9487) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 9371-33) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 9371-33) | |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2022-09-08 |