NPI | 1871796490 |
---|---|
Former Name | DONNA MARIE JEFFERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173416) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001277803) |
363LF0000X Nurse Practitioner, Family (Licence: TX 684854) | |
Enumeration Date | 2007-06-10 |
Last Update Date | 2023-11-17 |