| NPI | 1730630468 |
|---|---|
| Former Name | JESSICA MARIS MOATES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OK 82477) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: TX 862098) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OK 82477) | |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2021-03-16 |