Provider Demographics
NPI:1679208656
Name:JORDAN, COURTNEY BRIANNE (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:BRIANNE
Last Name:JORDAN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:404 TOWNSHIP ROAD 1204
Mailing Address - Street 2:
Mailing Address - City:PROCTORVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45669
Mailing Address - Country:US
Mailing Address - Phone:740-550-0968
Mailing Address - Fax:
Practice Address - Street 1:1600 MEDICAL CENTER DR STE G500
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3659
Practice Address - Country:US
Practice Address - Phone:304-691-1262
Practice Address - Fax:304-691-1666
Is Sole Proprietor?:No
Enumeration Date:2022-07-22
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV113676363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily