Individual
DAVID JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1304 FRANKLIN AVE, NORMAL, IL 61761-3558
(309) 454-1400
Mailing address
611 W. PARK ST., FAPC, URBANA, IL 61801
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.026243
IL
Other
Enumeration date
10/27/2022
Last updated
04/19/2023
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