Individual
AMY MARIE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1900 RIDGE RD STE 130, WEST SENECA, NY 14224-3332
(716) 675-0707
(716) 961-3706
Mailing address
1900 RIDGE RD STE 130, WEST SENECA, NY 14224-3332
(716) 675-0707
(716) 961-3706
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
2818501
NY
363LF0000X
Family Nurse Practitioner
Primary
345378
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05954178
—
NY
Enumeration date
04/07/2010
Last updated
05/13/2020
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