NPI | 1447745203 |
---|---|
Former Name | JACQUELYN MARIE EVERETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: IN 17001480A) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IN 27048486A) |
Enumeration Date | 2018-06-25 |
Last Update Date | 2018-06-25 |