| NPI | 1457945776 |
|---|---|
| Former Name | JACQUELYN DAVANZO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0028181) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH APRN.CNP.0028181) |
| Enumeration Date | 2021-02-26 |
| Last Update Date | 2024-02-08 |