NPI | 1427762335 |
---|---|
Former Name | JESSICA RENEE PERRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023000402) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2019013312) |
Enumeration Date | 2023-01-06 |
Last Update Date | 2023-01-06 |