| NPI | 1497574362 |
|---|---|
| Former Name | JENNIFER KISE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704356668) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704356668) |
| Enumeration Date | 2024-10-08 |
| Last Update Date | 2026-06-11 |