| NPI | 1962479774 |
|---|---|
| Former Name | JEANNE DIANE THACKER-ANDRADE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 573554) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: TX 573554) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2010-12-17 |