| NPI | 1134494750 |
|---|---|
| Former Name | JANESSA CARROLL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2012008030) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 53-76692-112) |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2023-11-10 |