| NPI | 1427474709 |
|---|---|
| Former Name | JESSICA LYNN KOPICKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209010963) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704279210) |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2020-10-13 |