Individual
MS. CRYSTAL D JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1114 THOMASVILLE ROAD SUITE E-1, TALLAHASSEE, FL 32303
(850) 771-5765
(850) 779-4744
Mailing address
1114 THOMASVILLE ROAD SUITE E-1, TALLAHASSEE, FL 32303
(850) 771-5765
(850) 779-4744
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
3017962
FL
363LF0000X
Family Nurse Practitioner
Primary
3017962
FL
363LF0000X
Family Nurse Practitioner
ARNP3017962
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308624100
—
FL
01
—
99388
MEDICARE PART B (GROUP ASSOCIATION)
FL
Enumeration date
08/29/2007
Last updated
11/07/2023
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