| NPI | 1063084119 |
|---|---|
| Former Name | JORDAN LEIGH JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 6870) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 294961) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 294961) | |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2022-07-19 |