NPI | 1588073654 |
---|---|
Former Name | JESSICA BETH GRAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9310066) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9310066) |
Enumeration Date | 2014-08-04 |
Last Update Date | 2021-06-08 |