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General NPI Number Information
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NPI Number | 1255784252
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Entity Type | Individual
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Provider Name | CARMELA JORDAN CNP
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Gender | Female
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Dates
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Enumeration Date | 07/14/2016
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Last Update Date | 07/14/2016
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Provider Practice Location Address
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Address Line | 3525 OLENTANGY RIVER RD SUITE 5320
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City | COLUMBUS
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State | OH
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Zip | 43214-3937
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Country | US
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Telephone | 800-231-3672
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Fax | 865-531-6978
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Provider Business Mailing Address
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Address Line | 3736 DOLOMITE DR
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City | COLUMBUS
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State | OH
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Zip | 43230-1183
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Country | US
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Telephone | 614-327-2666
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 019341
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License Number State | OH
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