Individual provider · Type 1 NPI

Jordan Black, CPNP-PC

Pediatric Nurse Practitioner · Town And Country, MO

NPI number 1902496540 Active

About NPI 1902496540

Jordan Black, CPNP-PC's National Provider Identifier is 1902496540, issued on Jan 18, 2021. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Town And Country, MO. The record was last updated on Jul 10, 2023.