| NPI | 1265985626 |
|---|---|
| Former Name | JENNIFER DONNELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA61021112) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM PA2017-0003) |
| 363A00000X Physician Assistant (Licence: WA PA61021112) | |
| 363A00000X Physician Assistant (Licence: TX PA11037) | |
| 363AM0700X Physician Assistant, Medical (Licence: NM PA2017-0003) | |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2025-05-27 |