Healthcare Provider Details

I. General information

NPI: 1013599950
Provider Name (Legal Business Name): JORDAN JORDAN-TOPP APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JORDAN MAHLER APRN

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 03/15/2022
Certification Date: 03/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9332 STATE ROAD 54 STE 400
TRINITY FL
34655-1810
US

IV. Provider business mailing address

18021 FRAME BND
LAND O LAKES FL
34638-7670
US

V. Phone/Fax

Practice location:
  • Phone: 727-372-4779
  • Fax: 727-372-4559
Mailing address:
  • Phone: 813-957-2729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11013735
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: