| NPI | 1912545195 |
|---|---|
| Other Name | ELLIE JORDAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007052) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 000000000) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: VA 000000000) | |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2024-04-01 |