NPI | 1417956590 |
---|---|
Former Name | JERRI LYNN ROBERTSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP104041) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 541369) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 541369) | |
Enumeration Date | 2005-07-20 |
Last Update Date | 2017-09-25 |