Individual
MRS. MELISSA ANNE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
500 W BROADWAY ST FL 3, MISSOULA, MT 59802-4008
(406) 327-1670
Mailing address
PO BOX 12, LIBERTY LAKE, WA 99019-0012
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
NUR RN LIC 21177
MT
Other
Enumeration date
08/03/2012
Last updated
02/18/2016
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