NPI | 1376904458 |
---|---|
Former Name | KIERRA AMANDA JACKSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367A00000X Advanced Practice Midwife |
Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: IL 104106320) |
367A00000X Advanced Practice Midwife (Licence: IL CNM07665) | |
374J00000X Doula | |
Enumeration Date | 2016-03-16 |
Last Update Date | 2022-07-06 |