| NPI | 1114368131 |
|---|---|
| Former Name | JESSICA CARRASQUILLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 40332.1643) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WY 40332.1643) |
| 363LF0000X Nurse Practitioner, Family (Licence: NE 111531) | |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2021-09-14 |