MEDICARE: JORDEN LOTT NP

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	363LA2100X	Acute Care Nurse Practitioner	11046593	FL

General Provider Information

NPI Number	:	1851233761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDEN LOTT NP

Provider Business Mailing Address
First Line	:	13215 ANTELOPE RUN
Second Line	:
City	:	SAINT HEDWIG
State	:	TX
Zip	:	78152-0107
Country	:	US
Telephone Number	:	940-249-2138
Fax Number	:

Provider Business Practice Location Address
First Line	:	13215 ANTELOPE RUN
Second Line	:
City	:	SAINT HEDWIG
State	:	TX
Zip	:	78152-0107
Country	:	US
Telephone Number	:	940-249-2138
Fax Number	:

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

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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