Individual
MR. JORDAN TIMOTHY HERBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AGPCNP-BC
Contact information
Practice address
32905 W 12 MILE RD STE 410, FARMINGTON HILLS, MI 48334-3346
(248) 957-9184
(248) 957-9185
Mailing address
21650 W 11 MILE RD STE 202, SOUTHFIELD, MI 48076-3777
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704293610
MI
363LP2300X
Primary Care Nurse Practitioner
4704293610
MI
Other
Enumeration date
12/21/2016
Last updated
04/11/2022
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