| NPI | 1073391926 |
|---|---|
| Former Name | JENNA LEE TYMKOWICHE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA rn2308152) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704424442) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP032120) | |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2025-03-13 |