| NPI | 1336453315 |
|---|---|
| Former Name | JANELLE MARIE KUBISIAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: WI 4113-033) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: WI 2009006582) |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2022-02-04 |