Individual provider · Type 1 NPI

Jodiey Bondurant, DNP, CPNP-PC/AC, FNP

Pediatric Nurse Practitioner · Portland, OR

NPI number 1104369917 Active

Practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Fax (503) 494-1542

Other practice locations

  • 1 Childrens Pl, St. Louis, MO 63110-1002 · (314) 454-6336
  • 2100 Madison Ave, Granite City, IL 62040-4713 · (618) 798-3000

Specialties and licenses

TaxonomyCodeLicense
Acute Care Nurse Practitioner 363LA2100X202101747NP-PP (OR)
Family Nurse Practitioner 363LF0000X202101747NP-PP (OR)
Pediatric Nurse Practitioner 363LP0200XAP60689542 (WA)
Pediatric Nurse Practitioner Primary 363LP0200X202101747NP-PP (OR)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1104369917

Jodiey Bondurant, DNP, CPNP-PC/AC, FNP's National Provider Identifier is 1104369917, issued on Nov 28, 2016. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Portland, OR. The record was last updated on Jul 19, 2023.