| NPI | 1831255330 |
|---|---|
| Former Name | JACQUELYN M LEAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5002506) |
| Additional Taxonomies | 163WP0000X Registered Nurse, Pain Management (Licence: NC 5002506) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2023-08-22 |