NPI | 1558756205 |
---|---|
Former Name | JACKLYN M HEDGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209012480) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.012480) |
363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.012480) | |
Enumeration Date | 2015-03-31 |
Last Update Date | 2025-04-28 |