| 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 |