Individual
MRS. MARIA VIRGINIA JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
19021 US HIGHWAY 285, LA JARA, CO 81140-9427
(719) 274-6000
(719) 274-6038
Mailing address
14499 COUNTY ROAD U, LA JARA, CO 81140-9594
(719) 274-5300
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
68339
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07683394
—
CO
Enumeration date
02/03/2006
Last updated
08/17/2011
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