NPI | 1104271113 |
---|---|
Former Name | MEGAN ELIZABETH JERMSTAD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP130349) |
Additional Taxonomies | 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: TX 831207) |
Enumeration Date | 2016-04-27 |
Last Update Date | 2016-05-11 |