| NPI | 1699555755 |
|---|---|
| Former Name | JENNIFER ELLEN FERNANDEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP031366) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 26560) |
| Enumeration Date | 2023-10-04 |
| Last Update Date | 2025-01-28 |