NPI | 1124438932 |
---|---|
Former Name | JENNIFER MEADE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014005298) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 76290) |
Enumeration Date | 2014-05-01 |
Last Update Date | 2022-01-15 |