| NPI | 1487080644 |
|---|---|
| Former Name | JESSICA SPARKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71004639A) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: IN 71004639A) |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2022-06-03 |