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Individual

JORDAN MERRYMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
4123 DUTCHMANS LN STE 606, LOUISVILLE, KY 40207-4725
(502) 896-2500
(502) 896-2527
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
3018509
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300071392
IN
05
7100873300
KY
Enumeration date
12/05/2022
Last updated
02/28/2023
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