NPI | 1134644396 |
---|---|
Other Name | SIMONE JACKSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV APRN002716) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP134295) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NV APRN002716) | |
Enumeration Date | 2017-08-09 |
Last Update Date | 2021-04-14 |