NPI | 1487102034 |
---|---|
Former Name | JENNIFER LEIGH SWANSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MI 4704257643) |
Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MI 4704257643) |
363LG0600X Nurse Practitioner Gerontology (Licence: MI 4704257643) | |
Enumeration Date | 2016-09-12 |
Last Update Date | 2021-02-15 |