NPI | 1245518927 |
---|---|
Former Name | JESSICA L HAASE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71014774A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.12439-NP) |
Enumeration Date | 2011-07-28 |
Last Update Date | 2024-04-05 |