| NPI | 1548916489 |
|---|---|
| Former Name | JACKLYNN M HEISLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2022006456) |
| Enumeration Date | 2022-03-01 |
| Last Update Date | 2024-04-15 |