| NPI | 1730788779 |
|---|---|
| Former Name | JACLYN ROSE KISH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: MA RN2264880) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2264880) |
| 363LN0000X Nurse Practitioner, Neonatal (Licence: MA RN2264880) | |
| 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: MA RN2264880) | |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2021-12-15 |