| NPI | 1023421344 |
|---|---|
| Former Name | JODY LYNN MADDEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: SC 27907) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: PA SP021525) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2024-11-04 |