Jordan, Tricia Frack

Jordan, Tricia Frack is an individual health care provider with primary practice located at 3300 Gallows Rd , Falls Church VA 22042-3307. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is her primary health care specialty. Jordan, Tricia Frack can be contacted via phone (707) 776-3138.

Contact Information

Primary practice address
3300 Gallows Rd Falls Church VA 22042-3307
Phone: (707) 776-3138
Fax: (703) 776-2623
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 0001162092 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 0024162092 Virginia

Profile Details

NPI number 1538107552
LBN Legal business name Jordan, Tricia Frack
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 3rd, 2006
Last updated May 22nd, 2014 - about 10 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 1538107552 NPPES
Maryland MEDICAID 0105051700
Maryland MEDICAID 010385903

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