| NPI | 1043661184 |
|---|---|
| Former Name | JORDAN BLANKMANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2021024545) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2016022515) |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2021-07-28 |