NPI | 1013696798 |
---|---|
Former Name | JACLYN GERARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4008949) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: KY 1138276) |
Enumeration Date | 2023-07-11 |
Last Update Date | 2024-06-25 |