| NPI | 1972199644 |
|---|---|
| Former Name | JORDAN NICOLE PATRICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 28834) |
| Additional Taxonomies | 363LS0200X Nurse Practitioner, School (Licence: TN 188484) |
| Enumeration Date | 2020-12-17 |
| Last Update Date | 2021-02-06 |