NPI | 1942544937 |
---|---|
Former Name | JENNIFER MARIE CONN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP5082) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: AZ RN126561) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP5082) | |
Enumeration Date | 2012-11-15 |
Last Update Date | 2023-03-30 |