Jordan, Jacquita
Jordan, Jacquita is an individual health care provider with primary practice located at 1259 Lake Plaza Dr Ste 270 , Colorado Springs CO 80906-3560. She recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Jordan, Jacquita can be contacted via phone (719) 653-7776.Contact Information
Primary practice address
1259 Lake Plaza Dr Ste 270
Colorado Springs CO 80906-3560
Phone: (719) 653-7776
Fax: (719) 207-7783
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207QA0401X | APN.0991885-NP | Colorado |
| Physician Assistants & Advanced Practice Nursing Providers / Acute Care | 363LA2100X | APN.0991885-NP | Colorado |
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 0991885 | Colorado |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | APN.0991885-NP | Colorado |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 0991885 | Colorado |
Profile Details
| NPI number | 1730558834 |
|---|---|
| LBN Legal business name | Jordan, Jacquita |
| Credentials | FNP-BC, AGACNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 18th, 2015 |
| Last updated | Feb 12th, 2024 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730558834 | NPPES |
| Colorado | MEDICAID | 42820065 | |
| Colorado | MEDICAID | 9000108092 |
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