NPI | 1689977027 |
---|---|
Former Name | JENNIFER MICHELLE NIEVAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: LA AP08570) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R879835) |
Enumeration Date | 2010-12-07 |
Last Update Date | 2016-11-14 |