NPI | 1750925475 |
---|---|
Former Name | JACQUELENE DIANE SCHIPPERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IA H091549) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IA H091549) |
Enumeration Date | 2019-11-06 |
Last Update Date | 2019-11-06 |