| NPI | 1356723217 |
|---|---|
| Former Name | JENNIFER DICKERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.17531) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704189540) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2024-07-15 |