| NPI | 1063475655 |
|---|---|
| Former Name | JEANNIE KRISTIN BOOHER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 6536) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71001126A) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2014-10-07 |