Healthcare Provider Details

I. General information

NPI: 1750685764
Provider Name (Legal Business Name): JORDAN MARIE MAGIERA A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JORDAN MARIE FRAZIER A.R.N.P

II. Dates (important events)

Enumeration Date: 01/05/2011
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13241 BARTRAM PARK BLVD SUITE 209
JACKSONVILLE FL
32258-5212
US

IV. Provider business mailing address

13241 BARTRAM PARK BLVD SUITE 209
JACKSONVILLE FL
32258-5212
US

V. Phone/Fax

Practice location:
  • Phone: 904-224-5437
  • Fax:
Mailing address:
  • Phone: 904-224-5437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP 9277629
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: