NPI | 1396744322 |
---|---|
Former Name | JENNIFER PATRICIA CORLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: WA RN00134242) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30006682) |
Enumeration Date | 2005-07-20 |
Last Update Date | 2007-07-08 |