Individual provider · Type 1 NPI
Lori Jordan Back, FNP-C
Family Nurse Practitioner · St. Petersburg, FL
NPI number
1639934102
Active
Practice location
5880 49th St N Unit N-201
St. Petersburg, FL 33709-2150
Mailing address
4540 Southside Blvd Ste 401
Jacksonville, FL 32216-5488
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 11031278 (FL) |
Family Nurse Practitioner: Definition to come...
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About NPI 1639934102
Lori Jordan Back, FNP-C's National Provider Identifier is 1639934102, issued on Feb 14, 2024. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in St. Petersburg, FL. The record was last updated on May 7, 2025.