MEDICARE: JERI LYNN JORDAN FNP-C

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	207Q00000X	Family Medicine Physician	211300	LA

General Provider Information

NPI Number	:	1952258162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JERI LYNN JORDAN FNP-C

Provider Business Mailing Address
First Line	:	1541 KINGS HWY
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71103-4228
Country	:	US
Telephone Number	:	318-626-0561
Fax Number	:	318-698-4306

Provider Business Practice Location Address
First Line	:	1541 KINGS HWY
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71103-4228
Country	:	US
Telephone Number	:	318-451-8573
Fax Number	:

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

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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