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NPI Code Detail

MEDICARE: MRS. JORDAN ELIZABETH PACILLA NP-C

MEDICARE: MRS. JORDAN ELIZABETH PACILLA NP-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 Practitioner0024178494VA

General Provider Information

NPI Number : 1225676174
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JORDAN ELIZABETH PACILLA NP-C
Provider Business Mailing Address
First Line : 160 WARRIOR DR
Second Line :
City : STEPHENS CITY
State : VA
Zip : 22655-4044
Country : US
Telephone Number : 540-868-4100
Fax Number : 540-868-0888
Provider Business Practice Location Address
First Line : 160 WARRIOR DR
Second Line :
City : STEPHENS CITY
State : VA
Zip : 22655-4044
Country : US
Telephone Number : 540-868-4100
Fax Number : 540-868-0888
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2019
Last Update Date : 12/19/2019

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