Individual
JORDAN JACKSON KAYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2430 EMERALD PL STE 103, GREENVILLE, NC 27834-5743
(252) 916-2133
Mailing address
2430 EMERALD PL STE 103, GREENVILLE, NC 27834-5743
(252) 752-2140
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
294961
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
6870
NC
390200000X
Student in an Organized Health Care Education/Training Program
294961
NC
Other
Enumeration date
07/16/2021
Last updated
07/19/2022
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