| NPI | 1063826212 |
|---|---|
| Former Name | JESSICA DAWN BLAIR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10043053) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 10043053) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2025-10-23 |