NPI | 1265735757 |
---|---|
Former Name | JILL ELIZABETH SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA 203897) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP011091) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: DC RN1018061) | |
Enumeration Date | 2010-12-06 |
Last Update Date | 2019-04-01 |