NPI | 1992204796 |
---|---|
Former Name | JADE C KOEUNE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 8247) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 197335) |
Enumeration Date | 2018-02-07 |
Last Update Date | 2025-09-22 |