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Individual
JORDON GRABAN
Active
Individual
JORDON GRABAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
774422
NY
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
774422
NY
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
774422
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
774422
NEW YORK STATE DEPARTMENT OF EDUCATION
NY
Enumeration date
10/13/2023
Last updated
10/13/2023
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