| NPI | 1780912204 |
|---|---|
| Former Name | JENNIFER L. WAAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209007794) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209-007794) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 5804-33) | |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2019-05-27 |