| NPI | 1063239846 |
|---|---|
| Former Name | JACQUELINE LEE MICHUDA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10033768) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 10033768) |
| 163W00000X Registered Nurse (Licence: IN 28301774A) | |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2026-05-26 |