NPI | 1285628883 |
---|---|
Former Name | JILL KIMBERLY SALATA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9341297) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9341297) |
363LF0000X Nurse Practitioner, Family (Licence: MD R130805) | |
363LF0000X Nurse Practitioner, Family (Licence: MN R 168491-7) | |
Enumeration Date | 2005-09-09 |
Last Update Date | 2024-09-16 |