| NPI | 1982257044 |
|---|---|
| Former Name | JORDAN ELIZABETH REYNOLDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2536) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2021-09-17 |