NPI | 1063826212 |
---|---|
Former Name | JESSICA DAWN BLAIR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH 332512) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 332512) |
Enumeration Date | 2014-06-16 |
Last Update Date | 2021-02-08 |