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 |