Individual
THOMAS JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14717 S MINUTEMAN DR, DRAPER, UT 84020-9549
(435) 835-8293
Mailing address
467 E 100 S, MANTI, UT 84642-1416
(435) 835-8293
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9100065-3102
UT
363LF0000X
Family Nurse Practitioner
Primary
9100065-4405
UT
Other
Enumeration date
10/17/2019
Last updated
07/15/2020
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