NPI | 1285115162 |
---|---|
Former Name | JESSICA NICOLE CONLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: MI 4704273953) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704273953) |
Enumeration Date | 2018-08-28 |
Last Update Date | 2018-09-24 |