| NPI | 1962767533 |
|---|---|
| Former Name | JENNIFER MARIE LANTGEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 455) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R179194-9) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2020-08-07 |