| NPI | 1568074359 |
|---|---|
| Former Name | JAMIE KIVISTO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9898) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 9898-33) |
| Enumeration Date | 2020-08-21 |
| Last Update Date | 2024-05-06 |