| NPI | 1649796913 |
|---|---|
| Former Name | JENNIFER ANN FOLSTAD |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 7918) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 7918-33) |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2025-02-10 |