MEDICARE: MRS. TIFFANY LYNN JORDAN CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN.CNP.0028325	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710290317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TIFFANY LYNN JORDAN CNP

Provider Business Mailing Address
First Line	:	329 N WEST ST
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45801-4331
Country	:	US
Telephone Number	:	419-221-3072
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 ARLINGTON AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-2598
Country	:	US
Telephone Number	:	419-383-6656
Fax Number	:	419-383-3167

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2010
Last Update Date	:	02/02/2024

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