Individual
JORDAN HARLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
213 N MAIN ST, MOSCOW, ID 83843-2700
(208) 882-7565
Mailing address
PO BOX 3687, COEUR D ALENE, ID 83816-2529
(208) 819-2183
(208) 209-6063
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2171158
ID
Other
Enumeration date
05/09/2025
Last updated
09/05/2025
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