NPI | 1700267689 |
---|---|
Former Name | JENNIFER GAYLE MEAD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5009081) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5009081) |
Enumeration Date | 2015-06-16 |
Last Update Date | 2019-03-26 |