Healthcare Provider Details

I. General information

NPI: 1063022887
Provider Name (Legal Business Name): JORDAN ALEXANDRA FRANCIS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2020
Last Update Date: 08/06/2020
Certification Date: 08/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 W MAIN ST
BATAVIA NY
14020-1347
US

IV. Provider business mailing address

300 WEST AVE
BROCKPORT NY
14420-1118
US

V. Phone/Fax

Practice location:
  • Phone: 585-599-6446
  • Fax:
Mailing address:
  • Phone: 585-637-3905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number345731
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: