Individual
JORDYN NICOLE DORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3333 N SEMINARY ST, GALESBURG, IL 61401-1251
(309) 344-6161
Mailing address
750 W OLD VINE ST, CANTON, IL 61520
(309) 259-0114
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041503368
IL
363LA2100X
Acute Care Nurse Practitioner
Primary
209024585
IL
Other
Enumeration date
12/16/2021
Last updated
12/22/2021
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