NPI | 1679243661 |
---|---|
Former Name | JORDAN MICHELE COLLINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 71012925A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28230999A) |
Enumeration Date | 2021-09-20 |
Last Update Date | 2024-01-11 |