| NPI | 1972149128 |
|---|---|
| Former Name | JESSICA LYNNE MILLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-169604) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-169604) |
| Enumeration Date | 2019-11-22 |
| Last Update Date | 2023-03-21 |