| NPI | 1053514612 |
|---|---|
| Former Name | JESSICA LEIGH LIESVELD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22415) |
| Additional Taxonomies | 176B00000X Midwife (Licence: SC 22415) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2021-06-16 |