| NPI | 1164920088 |
|---|---|
| Former Name | JENTRY ANN WHEATON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-201519) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 907091) |
| 363LF0000X Nurse Practitioner, Family (Licence: MT 139841) | |
| Enumeration Date | 2018-01-25 |
| Last Update Date | 2024-11-19 |