| NPI | 1295019701 |
|---|---|
| Former Name | JENNIFER LYNN SWANNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 12324764-1206) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: DC PA030782) |
| 363AS0400X Physician Assistant, Surgical (Licence: VA 0110003679) | |
| Enumeration Date | 2011-10-03 |
| Last Update Date | 2021-11-18 |