| NPI | 1396362125 |
|---|---|
| Former Name | JENNIFER LYN CAPPELLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12.009086) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 134738) |
| Enumeration Date | 2020-06-27 |
| Last Update Date | 2020-11-12 |