| NPI | 1861803108 |
|---|---|
| Former Name | DIANA S JORDAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN159335) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN159335) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2020-09-16 |