| NPI | 1629209028 |
|---|---|
| Former Name | JENNIFER LYNN BEAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71003589A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 6117P) |
| Enumeration Date | 2009-08-03 |
| Last Update Date | 2013-10-24 |