Individual
JORDAN BENTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
622 E TARPON AVE, TARPON SPRINGS, FL 34689-4202
(727) 434-2632
Mailing address
235 E COLLEGE AVE, UNIVERSITY PARK, PA 16802-4587
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN672214
PA
163W00000X
Registered Nurse
Primary
RN9413887
FL
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN9413887
FL
Other
Enumeration date
07/07/2025
Last updated
07/07/2025
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