Individual
JESSI RALSTON JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
222 E MEDICAL LN STE 400, WEST COLUMBIA, SC 29169-4848
(803) 794-7511
Mailing address
1601 GREENE ST, COLUMBIA, SC 29208-4001
(803) 777-7412
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
28157
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/11/2023
Last updated
03/25/2025
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