Individual
AMBRA JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3171 MAE AVE NE, BROOKHAVEN, GA 30319-2323
(404) 606-0084
Mailing address
3171 MAE, ATLANTA, GA 30319
(404) 606-0084
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN199382
GA
Other
Enumeration date
01/21/2015
Last updated
01/21/2015
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