NPI | 1740926799 |
---|---|
Former Name | JESSICA G LEVERING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022011604) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-81093-051) |
Enumeration Date | 2022-05-11 |
Last Update Date | 2023-04-18 |