| NPI | 1447765573 |
|---|---|
| Former Name | JENNIFER LATASHA BUGG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 1003310798) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175674) |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2023-09-06 |