Individual
JORDAN CAITLIN POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
607 PONDER PLACE DR, EVANS, GA 30809-3186
(762) 224-3027
(762) 208-4742
Mailing address
PO BOX 3788, COLUMBIA, SC 29230-3788
(803) 733-5969
(803) 753-5591
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
21658
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
NP001161
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP5129
—
SC
Enumeration date
04/09/2018
Last updated
02/24/2026
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