| NPI | 1912296419 |
|---|---|
| Former Name | JENNIFER ELIZABETH ELMORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 004621) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 4621) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2015-02-19 |