NPI | 1023034543 |
---|---|
Former Name | JENNIFER LYNN HAMM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A105742) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 105742) |
Enumeration Date | 2006-07-15 |
Last Update Date | 2021-05-28 |