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General NPI Number Information
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NPI Number | 1659058097
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Entity Type | Individual
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Provider Name | JORDAN LEVY
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Gender | Male
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Dates
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Enumeration Date | 06/28/2023
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 180 S FRONTAGE RD W
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City | VAIL
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State | CO
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Zip | 81657-5038
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Country | US
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Telephone | 970-476-2451
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6383
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City | EAGLE
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State | CO
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Zip | 81631-0016
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Country | US
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Telephone | 720-236-7252
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1000089-NP
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 1665218
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License Number State | CO
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