| NPI | 1144306549 |
|---|---|
| Former Name | JORDAN E MALLOY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60904961) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ID NP729A) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2018-12-14 |