| NPI | 1841562733 |
|---|---|
| Former Name | PAMELA SUZANNE JACKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 21608) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 277-003899) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 377-003662) | |
| 163W00000X Registered Nurse (Licence: IL 041-570423) | |
| 163W00000X Registered Nurse (Licence: CA 766010) | |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2025-10-07 |