NPI | 1124410758 |
---|---|
Former Name | JODI DOERRFELD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G159700) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 129164) |
Enumeration Date | 2015-02-18 |
Last Update Date | 2021-01-26 |