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Individual

MRS. JORDAN NICOLE DANIELS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
1718 PARR AVE STE A, DYERSBURG, TN 38024-2075
(731) 285-4104
(731) 285-8157
Mailing address
1718 PARR AVE STE A, DYERSBURG, TN 38024-2075
(731) 285-4104

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28834
TN
363LS0200X
School Nurse Practitioner
188484
TN

Other

Enumeration date
12/17/2020
Last updated
02/06/2021
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