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Individual

AMBROSHA NICOLE JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
3626 LATROBE DR, CHARLOTTE, NC 28211-1388
(704) 366-7182
(704) 366-7184
Mailing address
2266 N HIGHWAY 16, DENVER, NC 28037-8254
(704) 483-2200
(704) 483-2214

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
196518
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
196518
NC LICENSE
Enumeration date
03/12/2009
Last updated
07/26/2019
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