| NPI | 1366590408 |
|---|---|
| Former Name | JACQUELYN O WHEATLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN314815) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL arnp2606792) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2023-02-07 |