Provider Demographics
NPI:1609333871
Name:LEVANDOSKI, JORDAN GERARD (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:GERARD
Last Name:LEVANDOSKI
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JORDON
Other - Middle Name:
Other - Last Name:LEVANDOSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1735 S PUBLIC RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-7093
Mailing Address - Country:US
Mailing Address - Phone:303-665-3036
Mailing Address - Fax:
Practice Address - Street 1:1735 S PUBLIC RD STE 100
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026
Practice Address - Country:US
Practice Address - Phone:303-665-3036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0994489-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily