| NPI | 1366769226 |
|---|---|
| Former Name | JESSICA MARIE STINNETTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 25411) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2013-08-29 |