Individual
SUE-ELLEN JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
810 FAIRGROVE CHURCH RD, HICKORY, NC 28602-9617
(828) 326-3809
(828) 326-3371
Mailing address
146 MEDICAL PARK RD, STE 108, MOORESVILLE, NC 28117-8529
(704) 662-0877
(704) 662-0875
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
72862
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8052448
—
NC
Enumeration date
09/01/2006
Last updated
05/18/2016
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