| NPI | 1043986813 |
|---|---|
| Former Name | JESSICA FREDERICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11014414) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11014414) |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2021-09-28 |