NPI | 1104461672 |
---|---|
Former Name | JENNIFER LYNN LIBBY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: AZ RN156347) |
Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: AZ RN156347) |
Enumeration Date | 2019-11-08 |
Last Update Date | 2019-11-08 |