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General NPI Number Information
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NPI Number | 1487843926
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Entity Type | Individual
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Provider Name | BROOKE A JORDAN RN
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Gender | Female
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 10/22/2007
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Provider Practice Location Address
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Address Line | USAG ANSBACH HEALTH CLINIC UNIT 28614
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City | APO
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State | AE
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Zip | 09177
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Country | DE
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Telephone | 09802833398
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Fax |
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Provider Business Mailing Address
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Address Line | CMR 454 BOX 1905
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City | APO
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State | AE
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Zip | 09250
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Country | DE
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Telephone | 09802952775
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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 | RN 9261968
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1-107017
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License Number State | AL
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