Individual
JORDAN BROOKE CHILDRESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
105 W STONE DR STE 1F, KINGSPORT, TN 37660-3365
(423) 230-2420
(423) 230-2422
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024173715
VA
363LF0000X
Family Nurse Practitioner
Primary
29287
TN
Other
Enumeration date
04/13/2021
Last updated
04/04/2025
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