NPI | 1407281272 |
---|---|
Former Name | JACY F SUTTLEMEYER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: KS 76157) |
Enumeration Date | 2013-09-11 |
Last Update Date | 2021-03-24 |