| NPI | 1588861827 |
|---|---|
| Former Name | JENNIFER ANN THEIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MN R 174692-3) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 155412-030) |
| 164W00000X Licensed Practical Nurse (Licence: MN R 174692-3) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2007-07-08 |