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General NPI Number Information
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NPI Number | 1285204032
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Entity Type | Individual
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Provider Name | KALEIGH JORDAN IRISH APRN
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Gender | Female
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Dates
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Enumeration Date | 06/24/2021
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 13330 USF LAUREL DR
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City | TAMPA
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State | FL
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Zip | 33612-6601
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Country | US
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Telephone | 813-974-4683
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Fax |
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Provider Business Mailing Address
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Address Line | 331 NEWMAN SPRINGS RD STE 220
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City | RED BANK
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State | NJ
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Zip | 07701-5792
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Country | US
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Telephone | 732-807-0877
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Fax | 201-751-1680
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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 | 26NJ15106500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11013704
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License Number State | FL
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