NPI | 1710458328 |
---|---|
Former Name | JESSICA RIDLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011582) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC RIDL-19Q272) |
Enumeration Date | 2018-12-07 |
Last Update Date | 2024-09-23 |