NPI | 1346818838 |
---|---|
Former Name | MELISSA J JORDAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015847) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3015847) |
Enumeration Date | 2021-06-11 |
Last Update Date | 2021-09-03 |