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General NPI Number Information
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NPI Number | 1154055861
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Entity Type | Individual
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Provider Name | JENNIFER LYNN JORDAN AGNP
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Gender | Female
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Dates
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Enumeration Date | 07/11/2022
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 5735 MEEKER RD
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City | GREENVILLE
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State | OH
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Zip | 45331-1186
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Country | US
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Telephone | 937-548-9680
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Fax |
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Provider Business Mailing Address
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Address Line | 5735 MEEKER RD
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City | GREENVILLE
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State | OH
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Zip | 45331-1186
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Country | US
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Telephone | 937-548-9680
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.0028067
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0028067
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN.CNP.0028067
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License Number State | OH
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