Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | 4704224697 | MI |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 4704224697 | MI |
NPI | 1336383660 |
---|---|
Provider Name | Jenny K David |
First Address | West Branch, MI 48661 |
Second Address | Alger, MI 48610-9343 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2009 |
Last Update Date | 15/12/2015 |