| NPI | 1740710441 |
|---|---|
| Former Name | MALLORY JONES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209016055) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.016055) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2021-12-17 |