Individual
JORDAN EDWARD NUTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
510 RUBY FOREST PKWY, SUWANEE, GA 30024-3930
(770) 654-2171
Mailing address
510 RUBY FOREST PKWY, SUWANEE, GA 30024-3930
(770) 654-2171
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN172181
GA
Other
Enumeration date
09/09/2015
Last updated
09/09/2015
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