Individual
JORDYN ALEXIS GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1011 14TH AVE NW, ARDMORE, OK 73401-1828
(580) 223-5400
Mailing address
1710 JUNIPER LN, MIDLOTHIAN, TX 76065-9700
(214) 886-8858
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
219363
OK
Other
Enumeration date
07/15/2024
Last updated
08/15/2024
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