Provider Demographics
NPI:1003512997
Name:COURTRIGHT, JORDAN EMILY
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:EMILY
Last Name:COURTRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 OLD HERMITAGE RD
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-6461
Mailing Address - Country:US
Mailing Address - Phone:757-339-9359
Mailing Address - Fax:
Practice Address - Street 1:105 OLD HERMITAGE RD
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-6461
Practice Address - Country:US
Practice Address - Phone:757-339-9359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN731496163W00000X
VA0001280609163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse