Individual
MS. JORDAN SHANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1250 E MARSHALL ST, DEPT. OF INTERNAL MEDICINE/PULMONARY, RICHMOND, VA 23298-5051
(804) 828-9084
(804) 828-8891
Mailing address
PO BOX 91734, RICHMOND, VA 23291-1734
(804) 358-6100
(804) 342-7619
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110004417
VA
Other
Enumeration date
04/17/2013
Last updated
01/03/2020
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