NPI | 1124322292 |
---|---|
Former Name | JESSICA LESSNAU |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 995260) |
Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: CO 182349) |
363LF0000X Nurse Practitioner, Family (Licence: AZ 292945) | |
Enumeration Date | 2011-01-05 |
Last Update Date | 2024-02-05 |