NPI | 1700321387 |
---|---|
Former Name | JACLYN BURLESON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3016259) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9309418) |
Enumeration Date | 2017-01-05 |
Last Update Date | 2024-06-28 |