| NPI | 1164281259 | 
|---|---|
| Former Name | JENESSA JILL BLOTTER | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2024-03-19 | 
| Last Update Date | 2025-07-03 |