| NPI | 1245557859 |
|---|---|
| Former Name | JENNIFER LYN RENDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 14921) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: TN 14921) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2022-01-20 |