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General NPI Number Information
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NPI Number | 1437253978
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Entity Type | Individual
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Provider Name | JOSHUA E. JORDAN CRNA
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Gender | Male
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 04/20/2016
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Provider Practice Location Address
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Address Line | 1613 NW 136TH AVE #200
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City | SUNRISE
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State | FL
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Zip | 33323-2853
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Country | US
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Telephone | 954-838-2371
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Fax | 954-851-1758
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Provider Business Mailing Address
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Address Line | 45 NE LOOP 410 STE 900
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City | SAN ANTONIO
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State | TX
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Zip | 78216-5831
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Country | US
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Telephone | 210-375-7790
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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 | 694708
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License Number State | TX
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