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General NPI Number Information
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NPI Number | 1649070129
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Entity Type | Individual
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Provider Name | JORDAN LEIGH IREY APRN, NNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/14/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 1600 SW ARCHER RD
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City | GAINESVILLE
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State | FL
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Zip | 32610-3003
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Country | US
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Telephone | 352-265-0033
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100296
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City | GAINESVILLE
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State | FL
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Zip | 32610-0296
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Country | US
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Telephone | 352-273-8985
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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 | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | 11038194
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | APRN11038194
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License Number State | FL
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