NPI | 1508241506 |
---|---|
Former Name | JENELLE C VARGULICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9413215) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F339731-1) |
Enumeration Date | 2015-07-21 |
Last Update Date | 2021-08-10 |