| NPI | 1174853154 |
|---|---|
| Former Name | MICHELLE CHASE JORDAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 836228) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN148424) |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2014-01-07 |