| NPI | 1598107237 |
|---|---|
| Former Name | JACQUELYN LEE PRESTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2264) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 181234 9) |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2022-09-23 |