| NPI | 1285909887 | 
|---|---|
| Former Name | JESSICA D HERR | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP4384) | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ RN170733) | 
| Enumeration Date | 2012-03-14 | 
| Last Update Date | 2013-08-19 |