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1457702144
ALTA JORDAN
COLUMBIA, SC
NPI
1457702144
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2100X Nurse Practitioner, Acute Care
(Licence: SC 20190)
Enumeration Date
2016-06-24
Last Update Date
2021-08-25
Business Address
ALTA JORDAN AGACNP
1655 BERNARDIN AVE STE 220
COLUMBIA, SC 29204-2044
Phone number: 803-409-7170
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Mailing Address
ALTA JORDAN AGACNP
PO BOX 935722
ATLANTA, GA 31193-5722
Phone number: 843-792-6200
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