NPI | 1700163771 |
---|---|
Former Name | JESSICA LYNN YANUSZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5005386) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5005386) |
363LF0000X Nurse Practitioner, Family (Licence: NC 207353) | |
Enumeration Date | 2011-11-04 |
Last Update Date | 2024-09-19 |