Individual
JORDAN KNOWLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 SW ARCHER RD # 100371, GAINESVILLE, FL 32610-3003
(352) 265-7080
Mailing address
PO BOX 13833, PHILADELPHIA, PA 19101-3833
(352) 265-7080
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9299184
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012456000
—
FL
Enumeration date
06/11/2014
Last updated
08/25/2014
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