Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 2020040466 | AL |
NPI | 1023685716 |
---|---|
Provider Name | Jordan Layne Espersen |
First Address | Birmingham, AL 35242-6059 |
Second Address | Chapel Hill, NC 27517-4433 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2021 |
Last Update Date | 10/06/2021 |