NPI | 1578102257 |
---|---|
Former Name | JESSICA PATRICE PIERCE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024184897) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11005518) |
Enumeration Date | 2019-12-30 |
Last Update Date | 2024-08-15 |