Individual
JORDAN K PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
969 LAKELAND DR, JACKSON, MS 39216-4606
(601) 362-1990
Mailing address
PO BOX 4608, JACKSON, MS 39296
(334) 279-1450
(334) 279-1660
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R901564
MS
Other
Enumeration date
04/24/2019
Last updated
07/26/2019
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