NPI | 1427573260 |
---|---|
Former Name | ALYSSA JORDAN WARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL F06181825) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-141605) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 1-141605) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 2017023808) | |
Enumeration Date | 2017-08-12 |
Last Update Date | 2024-04-29 |