| NPI | 1073185583 |
|---|---|
| Former Name | JEANNIE DAWN BURCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP023887) |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2021-07-14 |