Individual
JORDAN MARIE DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
R104095
AR
363LG0600X
Gerontology Nurse Practitioner
Primary
215031
AR
Other
Enumeration date
03/12/2021
Last updated
05/04/2021
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