| NPI | 1831591684 |
|---|---|
| Former Name | JACQUELINE NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014032509) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2014032509) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2022-02-16 |