NPI | 1962154559 |
---|---|
Former Name | JESSIE C DECKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0030908) |
Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: OH RN.361849) |
363LF0000X Nurse Practitioner, Family (Licence: OH 2021185662) | |
Enumeration Date | 2022-01-25 |
Last Update Date | 2022-03-15 |