NPI | 1770880361 |
---|---|
Former Name | JESSICA LYNN GEDDES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA2018) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA21455) |
Enumeration Date | 2011-02-17 |
Last Update Date | 2021-05-26 |