NPI | 1902803208 |
---|---|
Former Name | JEAN MARIE DEFFNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ AP1972) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN090566) |
Enumeration Date | 2005-06-30 |
Last Update Date | 2019-02-25 |