NPI | 1144763301 |
---|---|
Former Name | JERI DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11002574) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA020211) |
Enumeration Date | 2016-11-21 |
Last Update Date | 2020-08-11 |