| NPI | 1700439353 |
|---|---|
| Former Name | JORDAN DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO APN.0994806-NP) |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2019-11-19 |