| NPI | 1124402904 |
|---|---|
| Former Name | JENNIFER JUANGA GRANDE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NJ 25NJ00574400) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00574400) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NJ00574400) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NJ 26NJ00574400) | |
| Enumeration Date | 2015-07-12 |
| Last Update Date | 2022-08-30 |