NPI | 1134361686 |
---|---|
Former Name | JANE LYNN CAMPBELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: GA RN201888) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN201888) |
Enumeration Date | 2009-03-30 |
Last Update Date | 2012-08-13 |