Individual
JEREMY DUGGER JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP, CPNP-AC
Contact information
Practice address
1600 7TH AVE S, CPPI 102, BIRMINGHAM, AL 35233-1711
(205) 638-3400
Mailing address
1720 2ND AVE S # NB308, BIRMINGHAM, AL 35294-1210
(205) 996-3651
(205) 996-7177
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-136533
AL
363LP0200X
Pediatric Nurse Practitioner
1-136533
AL
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
1-135633
AL
Other
Enumeration date
02/05/2015
Last updated
12/11/2017
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