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NPI Profile for JORDAN BLACK in TOWN AND COUNTRY, MO.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pediatrics |
363LP0200X | 50 | Nurse Practitioner |
| NPI # | 1902496540 |
|
| Status | Active | |
| Credentials | CPNP-PC | |
| Entity | Individual | |
| Enumeration date | 01/18/2021 | |
| Last updated | 07/10/2023 - About 3 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JORDAN BLACK
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JORDAN BLACK, CPNP-PC