| NPI | 1063826212 |
|---|---|
| Former Name | JESSICA DAWN BLAIR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/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 |