NPI | 1043090103 |
---|---|
Former Name | JENNIFER RUTH COOPER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OK 216100) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK R0130893) |
Enumeration Date | 2023-10-04 |
Last Update Date | 2024-01-09 |