NPI | 1063178812 |
---|---|
Former Name | JAMIE SUE WEIGEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 11545-33) |
Additional Taxonomies | 171000000X Military Health Care Provider (Licence: WI 11545-33) |
Enumeration Date | 2021-11-15 |
Last Update Date | 2025-01-21 |