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NPI Code Detail

MEDICARE: JORDAN WHEELER LPN

MEDICARE: JORDAN WHEELER LPN
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
1164W00000XLicensed Practical NurseLPN.149930.MEDS-IVOH

General Provider Information

NPI Number : 1346656899
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN WHEELER LPN
Provider Business Mailing Address
First Line : 2775 STATE ROUTE 39
Second Line :
City : SHELBY
State : OH
Zip : 44875-9466
Country : US
Telephone Number : 419-747-3322
Fax Number :
Provider Business Practice Location Address
First Line : 2775 STATE ROUTE 39
Second Line :
City : SHELBY
State : OH
Zip : 44875-9466
Country : US
Telephone Number : 419-747-3322
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/04/2014
Last Update Date : 07/09/2025

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