NPI | 1720678501 |
---|---|
Former Name | JESSICA ELAINE LANGHORNE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95031340) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95233156) |
Enumeration Date | 2021-01-25 |
Last Update Date | 2024-07-29 |