NPI | 1336563089 |
---|---|
Former Name | JESSICA SULSER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171518) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 60850) |
Enumeration Date | 2014-02-14 |
Last Update Date | 2021-03-07 |