| NPI | 1871370551 |
|---|---|
| Former Name | JACQUELINE V EDWARDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704222724NSA23OHI) |
| Enumeration Date | 2023-09-14 |
| Last Update Date | 2024-02-13 |