NPI | 1932790698 |
---|---|
Former Name | ALECIA LYNETTE JACOBS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO -APN.0002609-C-NP) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO C-RXN.0001215-C-NP) |
Enumeration Date | 2021-01-26 |
Last Update Date | 2021-10-26 |