NPI | 1013636265 |
---|---|
Former Name | JORDYN D NOULLET |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP026133) |
Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: PA SP026133) |
Enumeration Date | 2022-08-23 |
Last Update Date | 2023-11-27 |