Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 95001677 | CA |
NPI | 1003204504 |
---|---|
Provider Name | Ms. Alexandra Jordan Bandy |
First Address | Claremont, CA 91711 |
Second Address | Claremont, CA 91711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2015 |
Last Update Date | 06/01/2015 |