| NPI | 1982228847 |
|---|---|
| Former Name | JORDAN TAYLOR BACON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4205) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2024-07-08 |