NPI | 1679144364 |
---|---|
Former Name | JACQUELINE ANN MYETTE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2273331) |
Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: NH 065494-21) |
Enumeration Date | 2021-07-05 |
Last Update Date | 2021-12-12 |