Provider Demographics
NPI:1538058631
Name:GUY, JORDAN NICOLE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:NICOLE
Last Name:GUY
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 JODECO CT
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-5887
Mailing Address - Country:US
Mailing Address - Phone:404-353-1939
Mailing Address - Fax:
Practice Address - Street 1:449 JODECO CT
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-5887
Practice Address - Country:US
Practice Address - Phone:404-353-1939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38808363LP0808X
AL3-002314363LP0808X
GARN299795363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health