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Individual

MR. JORDAN BLAKE CARMEAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ACNP

Contact information

Practice address
971 LAKELAND DR STE 1052, JACKSON, MS 39216-4609
(601) 981-9503
(601) 982-0148
Mailing address
971 LAKELAND DR STE 1052, JACKSON, MS 39216-4609
(601) 981-9503
(601) 982-0148

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R890584
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R890584
MISSISSIPPI BOARD OF NURSING
MS
Enumeration date
05/15/2012
Last updated
05/15/2012
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