| NPI | 1851859250 |
|---|---|
| Former Name | JENNA ROSE LEVESQUE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP139527) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP139527) |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2022-08-11 |