| NPI | 1831556919 |
|---|---|
| Former Name | JENNIFER NICOLE MEDINA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95003670) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 775714) |
| 163WC1500X Registered Nurse Community Health (Licence: CA 78974) | |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2016-01-21 |