Healthcare Provider Details

I. General information

NPI: 1679208656
Provider Name (Legal Business Name): COURTNEY BRIANNE JORDAN APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2022
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 MEDICAL CENTER DR STE G500
HUNTINGTON WV
25701-3659
US

IV. Provider business mailing address

1448 10TH AVE STE 304
HUNTINGTON WV
25701-3579
US

V. Phone/Fax

Practice location:
  • Phone: 304-691-1262
  • Fax: 304-691-1666
Mailing address:
  • Phone: 304-399-7182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number113676
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: