| NPI | 1235880634 |
|---|---|
| Former Name | JESSICA DIANE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: GA RN259993) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN259993) |
| Enumeration Date | 2022-01-17 |
| Last Update Date | 2023-10-30 |