NPI | 1376070847 |
---|---|
Former Name | JANNA LYNN CONRAD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71007158A) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: IN 28135072A) |
Enumeration Date | 2017-05-16 |
Last Update Date | 2024-09-09 |