| NPI | 1073915146 |
|---|---|
| Former Name | JENNIFER LEA NEWBURG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 6185) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 146900) |
| Enumeration Date | 2014-09-20 |
| Last Update Date | 2016-08-14 |