NPI | 1093422636 |
---|---|
Former Name | JESSICA LANEICE JEFFERY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AK 236190) |
Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: AK 117979) |
Enumeration Date | 2022-11-02 |
Last Update Date | 2025-04-05 |