| NPI | 1518693571 |
|---|---|
| Former Name | JENNIFER LYNNETTE MEACHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 13132) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI F07220418) |
| Enumeration Date | 2022-08-01 |
| Last Update Date | 2022-12-09 |