NPI | 1750834057 |
---|---|
Former Name | JENNIFER ENZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 7104) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 141451) |
363LF0000X Nurse Practitioner, Family (Licence: WI 7104-33) | |
Enumeration Date | 2016-08-03 |
Last Update Date | 2025-04-01 |