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General NPI Number Information
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NPI Number | 1699262204
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Entity Type | Individual
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Provider Name | JORDAN ANNE DENISON PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/18/2018
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 550 PEACHTREE ST NE BLDG 3245A
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City | ATLANTA
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State | GA
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Zip | 30308
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Country | US
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Telephone | 404-686-4411
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Fax |
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Provider Business Mailing Address
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Address Line | 31 CHATUACHEE XING
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City | SAVANNAH
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State | GA
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Zip | 31411-1602
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Country | US
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Telephone | 828-234-7050
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 8775
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License Number State | GA
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