Individual
JORDAN GWINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
327 MEDICAL PARK DR, BRIDGEPORT, WV 26330-9006
(304) 293-2436
Mailing address
PO BOX 780, MORGANTOWN, WV 26507-0780
(304) 285-7101
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
77196
WV
Other
Enumeration date
03/13/2015
Last updated
05/08/2015
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