Jordan, Crystal D

Jordan, Crystal D is an individual health care provider with primary practice located at 1114 Thomasville Road Suite E-1 , Tallahassee FL 32303. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Nursing Service Providers / Emergency. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Jordan, Crystal D can be contacted via phone (850) 771-5765.

Contact Information

Primary practice address
1114 Thomasville Road Suite E-1 Tallahassee FL 32303
Phone: (850) 771-5765
Fax: (850) 779-4744
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP3017962 Florida
Nursing Service Providers / Emergency 163WE0003X 3017962 Florida
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3017962 Florida

Profile Details

NPI number 1750575064
LBN Legal business name Jordan, Crystal D
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2007
Last updated Nov 7th, 2023 - about last year

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 1750575064 NPPES
Florida MEDICAID 308624100
Florida Other 99388

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