| NPI | 1710759550 |
|---|---|
| Former Name | JENNEY JENEAN FRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61528738) |
| Enumeration Date | 2023-10-25 |
| Last Update Date | 2024-04-25 |