NPI | 1750819298 |
---|---|
Former Name | JESSICA A. WYGANT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP021221) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.391864) |
363LP2300X Nurse Practitioner, Primary Care (Licence: OH APRN.CNP.021221) | |
Enumeration Date | 2017-05-29 |
Last Update Date | 2021-02-19 |