NPI | 1770834483 |
---|---|
Former Name | JENNIE MARIE KNOB |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO APN0990465) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 0165688) |
Enumeration Date | 2012-09-21 |
Last Update Date | 2015-09-15 |