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NPI Code Detail

MEDICARE: PAUL JORDAN

MEDICARE:   PAUL  JORDAN
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
1163WC0200XCritical Care Medicine Registered Nurse4401009950MI

General Provider Information

NPI Number : 1447108980
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL JORDAN
Provider Business Mailing Address
First Line : 5801 S MCCLINTOCK DR STE 110
Second Line :
City : TEMPE
State : AZ
Zip : 85283-6002
Country : US
Telephone Number : 480-777-0900
Fax Number :
Provider Business Practice Location Address
First Line : 5801 S MCCLINTOCK DR STE 110
Second Line :
City : TEMPE
State : AZ
Zip : 85283-6002
Country : US
Telephone Number : 480-777-0900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2026
Last Update Date : 03/19/2026

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Directions to “ PAUL JORDAN ” Practice Location

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