Provider Demographics
NPI:1558835736
Name:ALLARD, JORDAN DAYNE (MSN, FNP)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:DAYNE
Last Name:ALLARD
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 VANDAMENT WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT ORAB
Mailing Address - State:OH
Mailing Address - Zip Code:45154-8311
Mailing Address - Country:US
Mailing Address - Phone:513-454-7246
Mailing Address - Fax:513-438-0202
Practice Address - Street 1:111 VANDAMENT WAY
Practice Address - Street 2:
Practice Address - City:MOUNT ORAB
Practice Address - State:OH
Practice Address - Zip Code:45154-8311
Practice Address - Country:US
Practice Address - Phone:513-454-7246
Practice Address - Fax:513-438-0202
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.024565363L00000X
OHRN.392657163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse