NPI | 1124329206 |
---|---|
Former Name | JAYCIE N ROOP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209008461) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209008461) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209008461) | |
Enumeration Date | 2010-11-05 |
Last Update Date | 2025-02-25 |