NPI | 1912695701 |
---|---|
Former Name | JANA BOUGHNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: CA 755874) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: CA 755874) |
Enumeration Date | 2023-04-28 |
Last Update Date | 2023-04-28 |