MEDICARE: JORDAN ARMANT

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	306184	MN

General Provider Information

NPI Number	:	1376368993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN ARMANT

Provider Business Mailing Address
First Line	:	4132 EDGEWOOD RD NE
Second Line	:
City	:	CIRCLE PINES
State	:	MN
Zip	:	55014-2443
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7831 GLENROY RD
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55439-3132
Country	:	US
Telephone Number	:	612-517-6622
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2024
Last Update Date	:	11/19/2024

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Directions to “ JORDAN ARMANT ” Practice Location

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