NPI | 1831825025 |
---|---|
Former Name | JESSICA KATHRYN EGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 089082-23) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NH 089082) |
Enumeration Date | 2022-07-28 |
Last Update Date | 2022-10-14 |