Individual
JORDAN RYAN KILGORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, AGACNP-BC
Contact information
Practice address
870 BOSTON TOWN RD, DUNLAP, TN 37327-4536
(423) 243-4812
Mailing address
870 BOSTON TOWN RD, DUNLAP, TN 37327-4536
(423) 243-4812
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
231456
TN
363LA2100X
Acute Care Nurse Practitioner
Primary
34441
TN
363LG0600X
Gerontology Nurse Practitioner
34441
TN
Other
Enumeration date
08/09/2023
Last updated
02/15/2024
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