Individual
DR. MARTI LIANNE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, NP
Contact information
Practice address
6051 U S HIGHWAY 49, HATTIESBURG, MS 39401-7200
(601) 288-1212
Mailing address
3019 MAGNOLIA PL, HATTIESBURG, MS 39402-2431
(601) 264-0696
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
212322
LA
363LF0000X
Family Nurse Practitioner
Primary
212322
LA
363LF0000X
Family Nurse Practitioner
R855681
MS
Other
Enumeration date
10/04/2006
Last updated
10/14/2020
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