Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 124Q00000X | Dental Hygienist | VA |
NPI | 1053843805 |
---|---|
Provider Name | Jean E Magee |
First Address | Stuarts Draft, VA 24477-2523 |
Second Address | Fishersville, VA 22939-2332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2017 |
Last Update Date | 21/02/2018 |