| NPI | 1508566860 |
|---|---|
| Former Name | JESSIE CORDELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: UT 7658870) |
| Enumeration Date | 2023-03-06 |
| Last Update Date | 2023-10-11 |