| NPI | 1982253316 | 
|---|---|
| Former Name | JESSICA C. ANDERSON | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN201807) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN201807) | 
| Enumeration Date | 2019-09-09 | 
| Last Update Date | 2019-09-09 |