NPI | 1215582549 |
---|---|
Former Name | JESSICA MARIE GRUWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA NP95035002) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: NM 57122) |
363L00000X Nurse Practitioner (Licence: NM 57122) | |
Enumeration Date | 2019-08-04 |
Last Update Date | 2025-08-07 |