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General NPI Number Information
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NPI Number | 1588549489
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Entity Type | Individual
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Provider Name | JORDAN LAMB FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/08/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 9140 W THOMAS RD STE B-106
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City | PHOENIX
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State | AZ
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Zip | 85037-3378
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Country | US
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Telephone | 623-939-1375
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Fax |
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Provider Business Mailing Address
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Address Line | 17223 W CARIBBEAN LN
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City | SURPRISE
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State | AZ
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Zip | 85388-7741
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Country | US
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Telephone | 201-989-9992
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 228357
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License Number State | AZ
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