| NPI | 1831728302 |
|---|---|
| Former Name | JENNIFER LEIGH HOGANCAMP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-174117) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-174117) |
| 247100000X Radiologic Technologist (Licence: 368880) | |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2022-05-28 |