| NPI | 1821618042 | 
|---|---|
| Former Name | JEANNE HEATH | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 071684-23) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0134678) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-17 | 
| Last Update Date | 2022-12-29 |