Individual
SHIKARA S JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-6744
Mailing address
4605 PINEHURST CT, HEPHZIBAH, GA 30815-4795
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
211773
GA
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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