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NPI Profile for JACKIE L WANTLAND in YAKIMA, WA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Wound Care |
163WW0000X |
| NPI # | 1134994916 |
|
| Status | Active | |
| Credentials | RN (Registered Nurse) | |
| Entity | Individual | |
| Enumeration date | 11/21/2023 | |
| Last updated | 11/21/2023 - About 3 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JACKIE L WANTLAND
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JACKIE L WANTLAND, RN