NPI | 1497034458 |
---|---|
Former Name | JESSICA NICOLE DRAIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP120667) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 724324) |
Enumeration Date | 2011-08-09 |
Last Update Date | 2018-03-17 |