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General NPI Number Information
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NPI Number | 1619832003
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Entity Type | Individual
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Provider Name | EMILY DEMING JORDAN PMHNP
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Gender | Female
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Dates
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Enumeration Date | 12/18/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 1001 NAVAHO DR STE 204
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City | RALEIGH
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State | NC
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Zip | 27609-7366
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Country | US
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Telephone | 919-917-7273
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Fax | 984-333-9160
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Provider Business Mailing Address
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Address Line | 4509 TETBURY PL
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City | RALEIGH
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State | NC
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Zip | 27613-4058
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Country | US
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Telephone | 919-607-9699
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5023655
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License Number State | NC
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