NPI | 1326665472 |
---|---|
Former Name | JESSICA LEIGH HARTMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: RI APRN02409) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: RI Rn54717) |
207Q00000X Family Medicine (Licence: RI APRN02409) | |
Enumeration Date | 2020-07-06 |
Last Update Date | 2023-07-13 |