NPI | 1972889400 |
---|---|
Former Name | AMYELLEN ELIZABETH JORGENSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: NE 111292) |
Enumeration Date | 2011-10-28 |
Last Update Date | 2016-05-27 |