| NPI | 1598214348 |
|---|---|
| Former Name | JESSICA ANN THIEME |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 7292) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 7292-33) |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2021-01-14 |