| NPI | 1144917691 |
|---|---|
| Former Name | JORDAN STANG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.0033231) |
| Enumeration Date | 2023-04-24 |
| Last Update Date | 2023-04-24 |