NPI | 1487332284 |
---|---|
Former Name | JONI MELINDA JACKSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA GAA-NP001470) |
Enumeration Date | 2023-07-11 |
Last Update Date | 2023-09-06 |