| NPI | 1568092989 |
|---|---|
| Former Name | JILLIAN MARIE RENGEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 24355) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5012737) |
| Enumeration Date | 2020-01-24 |
| Last Update Date | 2022-10-18 |