Individual
JORDAN HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1026 A AVE NE, CEDAR RAPIDS, IA 52402-5036
(319) 369-8600
(319) 369-7419
Mailing address
1026 A AVE NE, CEDAR RAPIDS, IA 52402-5036
(319) 369-8600
(319) 369-7419
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
090361
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090361
IOWA PA LICENSE
IA
Enumeration date
01/22/2018
Last updated
01/09/2020
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