| 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 |