| NPI | 1245670355 |
|---|---|
| Former Name | JESSICA MARIE SELLBOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA.11138-NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024172656) |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2016-04-21 |