| NPI | 1184049272 |
|---|---|
| Former Name | JENNIFER GACKSTETTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN AG0214065) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R 153889-8) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MN R 153889-8) | |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2014-02-26 |