| NPI | 1427421791 |
|---|---|
| Former Name | JESSICA A BOURBEAU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV 876757) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95003249) |
| Enumeration Date | 2015-11-08 |
| Last Update Date | 2024-10-01 |