NPI | 1619385119 |
---|---|
Former Name | JESSICA MARIE TERRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID NP-1690A) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60495206) |
363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP60495206) | |
363LF0000X Nurse Practitioner, Family (Licence: WA AP60495206) | |
Enumeration Date | 2014-07-28 |
Last Update Date | 2016-11-29 |