NPI | 1285157628 |
---|---|
Former Name | KAYLA JENSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95028328) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL TPAN2781) |
363LF0000X Nurse Practitioner, Family (Licence: TX AP134531) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP134531) | |
Enumeration Date | 2017-07-18 |
Last Update Date | 2024-10-23 |