Individual
DR. JULIE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2900 CHANCELLOR DR, CRESTVIEW HILLS, KY 41017-5427
(859) 341-0288
(859) 363-2140
Mailing address
2900 CHANCELLOR DR, CRESTVIEW HILLS, KY 41017-5427
(859) 341-0288
(859) 363-2140
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
38969
KY
207R00000X
Internal Medicine Physician
Primary
38969
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000360586
ANTHEM
—
01
—
310674100
FEDERAL BLACK LUNG
—
01
—
610677107043
CARESOURCE
OH
05
—
64100241
—
KY
01
—
7000160
AETNA
—
Enumeration date
06/23/2006
Last updated
03/18/2009
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