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 |