NPI | 1649057688 |
---|---|
Former Name | JILLIAN ROSE BALKENHOL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95031258) |
Additional Taxonomies | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: CA 95031258) |
163W00000X Registered Nurse (Licence: CT 153014) | |
163WP0218X Registered Nurse, Pediatric Oncology (Licence: CA 95328625) | |
163WP0218X Registered Nurse, Pediatric Oncology (Licence: CT 153014) | |
163W00000X Registered Nurse (Licence: CA 95328625) | |
Enumeration Date | 2023-09-13 |
Last Update Date | 2025-10-10 |