| NPI | 1760712616 |
|---|---|
| Other Name | JACKIE FERNANDES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: RI NPP37535) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: RI APRN00546) |
| Enumeration Date | 2009-12-28 |
| Last Update Date | 2024-08-01 |