NPI | 1437484300 |
---|---|
Former Name | JEANNE L SCULLY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R1345366) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R134536-6) |
Enumeration Date | 2009-10-12 |
Last Update Date | 2018-06-13 |