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General NPI Number Information
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NPI Number | 1164167680
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Entity Type | Individual
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Provider Name | JORDAN NICHOLE REPPOND APRN
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Gender | Female
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Dates
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Enumeration Date | 04/29/2022
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 6151 S YALE AVE
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City | TULSA
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State | OK
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Zip | 74136-1907
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Country | US
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Telephone | 918-494-8500
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Fax | 918-307-5578
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Provider Business Mailing Address
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Address Line | 1325 SAN MARCO BLVD STE 300
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8567
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Country | US
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Telephone | 904-253-6910
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Fax | 904-253-6964
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN11010199530
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License Number State | FL
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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 | 222458
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License Number State | OK
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