Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 11013615A | IN |
NPI | 1003070442 |
---|---|
Provider Name | Jennifer Marie Labrie-Deem |
First Address | Jamestown, IN 46147-8840 |
Second Address | Jamestown, IN 46147-8840 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2008 |
Last Update Date | 15/07/2008 |