| NPI | 1508549221 |
|---|---|
| Former Name | JILLENE J DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 14324) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: WI 14324-33) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 14324-33) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 14324-33) | |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2023-12-20 |