| NPI | 1366119653 | 
|---|---|
| Former Name | TATIYANA JENNINGS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP000384) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016575) | 
| Enumeration Date | 2021-08-25 | 
| Last Update Date | 2022-02-11 |