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General NPI Number Information
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NPI Number | 1235645110
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Entity Type | Individual
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Provider Name | JORDAN DENNIS DNP, CRNA
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Gender | Female
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Dates
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Enumeration Date | 12/14/2017
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 1210 S OLD DIXIE HWY
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City | JUPITER
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State | FL
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Zip | 33458-7205
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Country | US
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Telephone | 423-384-9899
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Fax |
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Provider Business Mailing Address
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Address Line | 11419 178TH RD N
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City | JUPITER
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State | FL
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Zip | 33478-4750
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Country | US
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Telephone | 423-384-9899
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | ARNP9394739
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 9394739
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License Number State | FL
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