| NPI | 1083963862 |
|---|---|
| Former Name | JESSICA RYAN O'BRIEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP012546) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN56548) |
| 363L00000X Nurse Practitioner (Licence: PA SP012546) | |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2020-12-19 |