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General NPI Number Information
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NPI Number | 1528831815
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Entity Type | Individual
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Provider Name | JORDAN LUEDY APRN-CRNA
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Gender | Female
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Dates
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Enumeration Date | 10/30/2023
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 6500 38TH AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33710-1629
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Country | US
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Telephone | 727-384-1414
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Fax |
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Provider Business Mailing Address
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Address Line | 2004 TREADWAY AVE
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City | CLEVELAND
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State | OH
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Zip | 44109-3657
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN.452901
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 153319
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License Number State | OH
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