| NPI | 1962110486 |
|---|---|
| Former Name | CASSIE MARIE JURGENSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.026603) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041407750) |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2023-01-31 |