NPI | 1497172399 |
---|---|
Former Name | JILL PETERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: IL 209011410) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209011410) |
Enumeration Date | 2014-03-28 |
Last Update Date | 2025-03-24 |