| NPI | 1609396639 |
|---|---|
| Former Name | JACLYN NOVAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5195) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 5195) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2021-04-28 |