Jordan, Stephanie D

Jordan, Stephanie D is an individual health care provider with primary practice located at 9263 Medical Plaza Dr Ste E, Charleston SC 29406-7112. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Jordan, Stephanie D can be contacted via phone (843) 572-1228.

Contact Information

Primary practice address
9263 Medical Plaza Dr Ste E Charleston SC 29406-7112
Phone: (843) 572-1228
Fax: (877) 561-7564
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X APN2789 South Carolina

Profile Details

NPI number 1588631097
LBN Legal business name Jordan, Stephanie D
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 2nd, 2006
Last updated Jun 1st, 2012 - about 12 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 1588631097 NPPES
South Carolina MEDICAID AN1466

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