NPI | 1023488939 |
---|---|
Former Name | JENNY LYNN DICKSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: GA 7759) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 7759) |
Enumeration Date | 2015-10-05 |
Last Update Date | 2019-04-22 |