Individual
PATRICIA W JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1615 MCMINNVILLE HWY, MANCHESTER, TN 37355-3179
(931) 728-6205
(931) 728-9818
Mailing address
100 WILLIAM NORTHERN BLVD, TULLAHOMA, TN 37388-4754
(931) 454-0489
(931) 454-2348
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN05312
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3347158
—
TN
01
—
4139434
BLUE CROSS
TN
Enumeration date
09/16/2006
Last updated
07/09/2007
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