Individual
NANCY L JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
911 ELLIS AVE, JACKSON, MS 39209-6256
(601) 533-7016
Mailing address
PO BOX 746085, ATLANTA, GA 30374-6085
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R857538
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03426357
—
MS
01
—
R857538
RN
MS
Enumeration date
03/05/2007
Last updated
09/06/2024
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