Roberson, Jordan

Roberson, Jordan is an sole proprietor health care provider with primary practice located at 725 W Granada Blvd Ste 30 , Ormond Beach FL 32174-9406. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Roberson, Jordan can be contacted via phone (386) 238-9095.

Contact Information

Primary practice address
725 W Granada Blvd Ste 30 Ormond Beach FL 32174-9406
Phone: (386) 238-9095
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 9410928 Florida

Profile Details

NPI number 1669965000
LBN Legal business name Roberson, Jordan
Credentials ARNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 11th, 2018
Last updated Jun 10th, 2024 - about 5 months 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 1669965000 NPPES
Florida MEDICAID 100175900

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