NPI | 1255813218 |
---|---|
Former Name | MICHELLE CHRISTINE JANSSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.017945) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.017945) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209-017945) | |
Enumeration Date | 2018-09-05 |
Last Update Date | 2024-01-29 |