NPI | 1760806632 |
---|---|
Former Name | JADE POWELL WARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 18347) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 18347) |
Enumeration Date | 2014-02-12 |
Last Update Date | 2015-04-15 |