Individual provider · Type 1 NPI
Jordan Ashley Ide
Medical-Surgical Registered Nurse · Gallup, NM
NPI number
1679188676
Active
Practice location
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical-Surgical Registered Nurse Primary | 163WM0705X | 60565 (NM) |
Medical-Surgical Registered Nurse: Definition to come...
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About NPI 1679188676
Jordan Ashley Ide's National Provider Identifier is 1679188676, issued on Sep 15, 2020. The primary taxonomy on file is Medical-Surgical Registered Nurse (163WM0705X), and the practice location is in Gallup, NM. The record was last updated on Sep 15, 2020.