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Individual
MS. STEPHANIE GOULD JORDAN
Active
Individual
MS. STEPHANIE GOULD JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
600122
NC
363LF0000X
Family Nurse Practitioner
Primary
600122
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7004154
—
NC
01
—
P00385661
RAILROAD MEDICARE
—
Enumeration date
11/22/2005
Last updated
10/24/2023
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