NPI | 1750066700 |
---|---|
Former Name | JESSICA MARIE SHIPPEE MCDANIEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 53-84481-122) |
Additional Taxonomies | 163WM0705X Registered Nurse Medical-Surgical (Licence: KS 594389) |
Enumeration Date | 2023-06-19 |
Last Update Date | 2025-06-19 |