| NPI | 1003255266 |
|---|---|
| Former Name | CRYSTAL MARIE JORDAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.14867) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.14867-NP) |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2024-12-12 |