NPI | 1790988913 |
---|---|
Former Name | JEAN NEWBY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 7007) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: WI 1760-029) |
Enumeration Date | 2007-06-06 |
Last Update Date | 2019-10-16 |