NPI | 1194807966 |
---|---|
Former Name | JEANINE ELAINE DAVIES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 277-000761) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71005498A) |
363LF0000X Nurse Practitioner, Family (Licence: IL 277-000761) | |
Enumeration Date | 2006-10-20 |
Last Update Date | 2023-05-05 |