| NPI | 1205131497 |
|---|---|
| Former Name | JENNA LAYNE CARLSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-109200) |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2011-12-20 |