NPI | 1619003761 |
---|---|
Former Name | JIMMICA WATKINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95028957) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 796326) |
164X00000X Licensed Vocational Nurse (Licence: CA VN199452) | |
Enumeration Date | 2007-02-25 |
Last Update Date | 2024-02-05 |