NPI | 1528319654 |
---|---|
Former Name | JENNA AUTUMN STUBBS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NC 5007159) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: NM CNP02053) |
Enumeration Date | 2012-09-28 |
Last Update Date | 2016-12-28 |