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:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1750952867 | NPPES |
Ohio | MEDICAID | 0453891 |
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