Individual
MS. JORDAN RAE DASILVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
631 PROFESSIONAL DR STE 360, LAWRENCEVILLE, GA 30046-3370
(678) 312-2700
Mailing address
635 ORA AVE SE UNIT B, ATLANTA, GA 30316-2145
(774) 688-9180
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
GA
Other
Enumeration date
11/24/2014
Last updated
01/29/2024
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