Individual
MELANIE TRUESDALE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
115 N SUMTER ST STE 400, SUMTER, SC 29150-4971
(803) 774-9465
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
21217
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP4789
—
SC
Enumeration date
08/24/2017
Last updated
01/17/2019
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