NPI | 1134451453 |
---|---|
Former Name | MELANIE ANN JESKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76353-032) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2010004418) |
Enumeration Date | 2010-02-11 |
Last Update Date | 2014-07-09 |