| NPI | 1043503956 |
|---|---|
| Former Name | JENNIFER ANNE KNUDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT 100480) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT 27449) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2023-11-09 |