Individual provider · Type 1 NPI

Antionette Jordan

Nurse Practitioner · St. Louis, MO

NPI number 1275249237 Active

Practice location

10004 Kennerly Rd Ste 374B
St. Louis, MO 63128-2178

Call (314) 842-9669 Map

Fax (314) 842-1017

Mailing address

PO Box 802841
Kansas City, MO 64180-2841

Specialties and licenses

Taxonomy	Code	License
Nurse Practitioner Primary	363L00000X	2022047351 (MO)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1275249237

Antionette Jordan's National Provider Identifier is 1275249237, issued on Jan 24, 2023. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in St. Louis, MO. The record was last updated on Aug 6, 2023.