| NPI | 1669761680 |
|---|---|
| Former Name | JENNIFER LAUREN PRESCOTT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3617) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9105939) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2020-08-13 |