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Individual

DR. IRMA L JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP, FNP/PMHNP-BC

Contact information

Practice address
4829 S COTTAGE GROVE AVE, CHICAGO, IL 60615-1600
(773) 548-1170
Mailing address
877 MADISON AVE # 663, MEMPHIS, TN 38103-3408
(901) 448-6161
(901) 448-4121

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5186
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.021887
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3904471
TN
Enumeration date
07/27/2006
Last updated
10/16/2020
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