Individual
JORDAN H. CROSBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
203 MILLS AVENUE, GREENVILLE, SC 29605-4019
(864) 271-1844
(864) 271-2147
Mailing address
203 MILLS AVENUE, CAROLINA NEPHROLOGY, PA, GREENVILLE, SC 29605-4019
(864) 271-1844
(864) 271-2147
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1835
SC
363AM0700X
Medical Physician Assistant
1835
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1510PA
—
SC
Enumeration date
10/09/2012
Last updated
03/23/2016
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