CHARLES RAYMOND JORDAN

GRENADA, MS
NPI1306126263
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MS  r869908)
Enumeration Date2011-08-24
Last Update Date2011-08-24
Business Address
Mr. CHARLES RAYMOND JORDAN FNP
1350 SUNSET DR STE B
GRENADA, MS 38901-4079
Phone number: 662-466-3632
Mailing Address
Mr. CHARLES RAYMOND JORDAN FNP
PO BOX 395
N.CARROLLTON, MS 38947-0395
Phone number: 662-466-3632
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