NPI | 1982213617 |
---|---|
Professional Name | JODI MARIE TICHENOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 114389) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-81263-042) |
Enumeration Date | 2020-07-28 |
Last Update Date | 2022-09-20 |