| NPI | 1295955284 |
|---|---|
| Former Name | JENNIFER LEE WALTERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209006581) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 156039) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2010-04-16 |