NPI | 1568135754 |
---|---|
Former Name | JANSEN LORRAINE SIA LLORICO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1158668) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN478812) |
363L00000X Nurse Practitioner (Licence: OH APRN.CNP.003530) | |
Enumeration Date | 2021-07-26 |
Last Update Date | 2024-05-20 |