Individual
STACI JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
314 GEORGE ST STE 314, BECKLEY, WV 25801-2653
(304) 252-8070
Mailing address
7994 MUDDY CREEK MOUNTAIN RD, LEWISBURG, WV 24901-9650
(304) 661-0735
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
70602
WV
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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