| NPI | 1780279653 |
|---|---|
| Former Name | JORDAN ALLAINA BRISTOW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA N36115055) |
| Enumeration Date | 2021-03-03 |
| Last Update Date | 2024-08-28 |