NPI | 1588159594 |
---|---|
Former Name | JESSICA LYNN DUDLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP030487) |
Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: MD R197315) |
Enumeration Date | 2018-06-22 |
Last Update Date | 2025-08-27 |