Individual
KIRSTEN JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
505 FRONT ST, FAIRFAX, IA 52228-9524
(402) 212-5634
Mailing address
505 FRONT ST, FAIRFAX, IA 52228-9524
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
C173667
IA
Other
Enumeration date
03/29/2023
Last updated
03/29/2023
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