Diana, Jordan

Diana, Jordan is an sole proprietor health care provider with primary practice located at 7630 Southern Blvd , Youngstown OH 44512-5633. He recently has 4 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Student, Health Care / Student in an Organized Health Care Education/Training Program. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is his primary health care specialty. Diana, Jordan can be contacted via phone (330) 729-8000.

Contact Information

Primary practice address
7630 Southern Blvd Youngstown OH 44512-5633
Phone: (330) 729-8000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X APRN.CNP.0029271 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APRN.CNP.0029271 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 364SA2200X APRN.CNP.0029271 Ohio
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1750952867
LBN Legal business name Diana, Jordan
Credentials AGNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 9th, 2021
Last updated Aug 26th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750952867 NPPES
Ohio MEDICAID 0453891

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