Individual
JORDAN LYNN CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2115 S FREMONT AVE, SPRINGFIELD, MO 65804-2239
(417) 820-3554
Mailing address
302 WILLEY ST, WILLARD, MO 65781-9774
(417) 597-2822
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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