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Individual

DR. JORDAN LEE NORDQUIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4901 THOMPSON PKWY, JOHNSTOWN, CO 80534-6426
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
10033
SD
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
DR.0064502
CO
390200000X
Student in an Organized Health Care Education/Training Program
565422
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
029064
KAISER COMMERCIAL NUMBER
CO
Enumeration date
06/14/2012
Last updated
06/17/2021
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