| NPI | 1932370756 |
|---|---|
| Other Name | JODI M WALLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WA AP30006123) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 091000332N2-PNP-PP) |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2018-03-17 |