Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | AP144491 | TX |
NPI | 1013520261 |
---|---|
Provider Name | Jasmine Gianni Nurse |
First Address | Converse, TX 78109-2600 |
Second Address | Lackland Afb, TX 78236-5638 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2020 |
Last Update Date | 27/08/2020 |