NPI | 1780141440 |
---|---|
Former Name | JENNIFER PATRICIA WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 11214) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60938189) |
Enumeration Date | 2019-02-28 |
Last Update Date | 2024-05-07 |