| NPI | 1619203072 |
|---|---|
| Former Name | JACKIE RACHELLE KOSLAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM R51858) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM CRNA-01067) |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2022-06-27 |