| NPI | 1235600404 |
|---|---|
| Former Name | BAILEY JO HENINGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP002540) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SD R047564) |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2022-12-13 |