NPI | 1972294502 |
---|---|
Former Name | JESSICA MARIE KRAWZIK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 4002490) |
Enumeration Date | 2023-05-16 |
Last Update Date | 2023-11-02 |