NPI | 1528542354 |
---|---|
Former Name | JENNIFER LYNN IPPEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176226) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024176226) |
Enumeration Date | 2018-09-18 |
Last Update Date | 2018-09-25 |