NPI | 1467759035 |
---|---|
Former Name | JACLYN HALEY BENNINGFIELD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: KY 3006642) |
Enumeration Date | 2011-02-17 |
Last Update Date | 2024-08-06 |