| NPI | 1629141825 |
|---|---|
| Former Name | JENNIFER MARGARET IBAUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0001123055) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024123055) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2007-07-08 |