| NPI | 1629645353 |
|---|---|
| Former Name | JORDAN MICHELLE LACY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1046041) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 133644) |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2023-10-02 |