NPI | 1578937926 |
---|---|
Former Name | JENNIFER NICHOLE BARTOLD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015039025) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 228946) |
363LF0000X Nurse Practitioner, Family (Licence: DE LG-0013148) | |
363LF0000X Nurse Practitioner, Family (Licence: KY 4034440) | |
Enumeration Date | 2015-11-23 |
Last Update Date | 2025-07-24 |