NPI | 1407215296 |
---|---|
Former Name | JESSICA FORT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: OH RN-318067) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN-318067) |
Enumeration Date | 2016-02-22 |
Last Update Date | 2016-02-22 |