| NPI | 1073768990 |
|---|---|
| Former Name | JESSICA LYNN ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9283140) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9283140) |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2013-12-20 |