Taylor, Jordan E

Taylor, Jordan E is an individual health care provider with primary practice located at 700 W Ironwood Dr Suite 155, Coeur D Alene ID 83814-2656. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Taylor, Jordan E can be contacted via phone (208) 667-0585.

Contact Information

Primary practice address
700 W Ironwood Dr Suite 155 Coeur D Alene ID 83814-2656
Phone: (208) 667-0585
Fax: (208) 667-0876
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X NP729A Idaho
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP60904961 Washington

Profile Details

NPI number 1144306549
LBN Legal business name Taylor, Jordan E
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2006
Last updated Dec 14th, 2018 - about 6 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 1144306549 NPPES
Idaho Other NPXN3 BLUE CROSS
Idaho MEDICAID 9653353 BLUE CROSS
Idaho Other NPXN2 BLUE CROSS
Idaho MEDICAID 1047507 BLUE CROSS
Idaho Other AP60904961 BLUE CROSS
Idaho Other 000010153954 BLUE CROSS
Idaho MEDICAID 1144306549 BLUE CROSS
Idaho MEDICAID 807343600 BLUE CROSS
Idaho MEDICAID NP708ID BLUE CROSS
Idaho Other 000010153955 BLUE CROSS

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