NPI | 1184385049 |
---|---|
Former Name | JESSICA TAYLOR MOORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704342229) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: MI 4704342229) |
Enumeration Date | 2022-01-04 |
Last Update Date | 2022-10-25 |