Individual
MRS. SHANNON NICHOLE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
6915 CRUMPLER BLVD STE C, OLIVE BRANCH, MS 38654-1907
(662) 874-5929
Mailing address
6915 CRUMPLER BLVD STE C, OLIVE BRANCH, MS 38654-1907
(662) 874-5929
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
906721
MS
Other
Enumeration date
06/24/2024
Last updated
04/09/2025
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