NPI | 1114916285 |
---|---|
Former Name | JENNIFER L. HUSEBOE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA J094265) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA H-094265) |
Enumeration Date | 2005-10-20 |
Last Update Date | 2020-11-19 |