| NPI | 1174661094 |
|---|---|
| Former Name | JENNIFER HARDEGEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R111615) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD 0314048) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2021-02-15 |