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Individual

RAVEN JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
215 N ALLISON AVE, BARBOURVILLE, KY 40906-1336
(606) 546-9287
Mailing address
18 GRANGER CT, BARBOURVILLE, KY 40906-7212
(606) 627-4235

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3015160
KY

Other

Enumeration date
10/07/2020
Last updated
09/22/2021
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