NPI | 1023551223 |
---|---|
Former Name | HOLLY V JACKSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: FL APRN11003757) |
Additional Taxonomies | 367A00000X Advanced Practice Midwife (Licence: CO APN.0992736-CNM) |
Enumeration Date | 2016-11-21 |
Last Update Date | 2024-04-15 |