NPI | 1487925715 |
---|---|
Other Name | MICHELLE L JENNINGS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 2281) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA07522) |
363AM0700X Physician Assistant, Medical (Licence: OK 2281) | |
Enumeration Date | 2012-01-18 |
Last Update Date | 2025-01-15 |