| NPI | 1104328616 |
|---|---|
| Former Name | JENNIFER BECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5697) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 5697) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 5697) | |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2018-03-01 |