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General NPI Number Information
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NPI Number | 1295284172
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Entity Type | Individual
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Provider Name | JORDAN PLAXICO RN, MSN, APRN, PMHNP
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Gender | Female
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Dates
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Enumeration Date | 10/03/2016
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Last Update Date | 08/10/2022
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Provider Practice Location Address
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Address Line | 210 WESTWOOD PL STE 110
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City | BRENTWOOD
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State | TN
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Zip | 37027-7554
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Country | US
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Telephone | 615-206-2462
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Fax | 833-983-2043
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Provider Business Mailing Address
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Address Line | 719 THOMPSON LN STE 30330
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City | NASHVILLE
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State | TN
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Zip | 37204-4701
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 210223
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 22109
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License Number State | TN
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