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NPI Code Detail

MEDICARE: MICHELLE L JORDAN CRNA

MEDICARE: MICHELLE L JORDAN CRNA
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
1367500000XCertified Registered Nurse AnesthetistARNP9233886FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G4742OTHERFLBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760622492
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE L JORDAN CRNA
Provider Business Mailing Address
First Line : 2500 HARBOR BLVD
Second Line :
City : PORT CHARLOTTE
State : FL
Zip : 33952-5000
Country : US
Telephone Number : 941-766-4125
Fax Number : 941-766-4101
Provider Business Practice Location Address
First Line : 2500 HARBOR BLVD
Second Line :
City : PORT CHARLOTTE
State : FL
Zip : 33952-5000
Country : US
Telephone Number : 941-766-4125
Fax Number : 941-766-4101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2009
Last Update Date : 02/08/2026

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