NPI | 1124558192 |
---|---|
Former Name | JESSICA ALDRIDGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP022913) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX AP134115) |
Enumeration Date | 2017-06-13 |
Last Update Date | 2021-02-09 |