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NPI Code Detail

MEDICARE: MRS. BRANDY M JORDAN MSN, APRN, FNP-C

MEDICARE: MRS. BRANDY M JORDAN MSN, APRN, FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAPRN.CNP.023719OH

General Provider Information

NPI Number : 1184191835
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRANDY M JORDAN MSN, APRN, FNP-C
Provider Business Mailing Address
First Line : 1075 N WASHINGTON ST
Second Line :
City : GREENFIELD
State : OH
Zip : 45123-9780
Country : US
Telephone Number : 937-981-9444
Fax Number :
Provider Business Practice Location Address
First Line : 1075 N WASHINGTON ST
Second Line :
City : GREENFIELD
State : OH
Zip : 45123-9780
Country : US
Telephone Number : 937-981-9444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2018
Last Update Date : 09/17/2021

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