| NPI | 1396089439 |
|---|---|
| Former Name | JEANIE MARIE LIGHTFOOT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60510299) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2021-07-29 |