Individual
LILLY NICOLE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
701 GROVE RD, GREENVILLE, SC 29605-4295
(864) 455-7844
Mailing address
8206 GLEN FOREST DR APT 8206, GREENVILLE, SC 29607-6117
(502) 419-2046
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
LL94438
SC
208000000X
Pediatrics Physician
LL94438
SC
Other
Enumeration date
03/30/2023
Last updated
07/29/2025
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