| NPI | 1740447606 |
|---|---|
| Former Name | VICKI GRACE JEMISON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 376K00000X Nurse's Aide |
| 246RP1900X Technician, Pathology, Phlebotomy | |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2011-04-05 |