| NPI | 1346015849 | 
|---|---|
| Former Name | JORDAN ELIZABETH SMALL | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1156436) | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2023041526) | 
| Enumeration Date | 2023-11-15 | 
| Last Update Date | 2025-10-28 |