| NPI | 1134424104 |
|---|---|
| Former Name | JENNIFER STAFSLIEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 4336) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 4336-33) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA 126937) | |
| Enumeration Date | 2011-01-21 |
| Last Update Date | 2023-01-03 |