Provider Demographics
NPI:1629768569
Name:JORDAN, ALEXANDRIA ELAINE (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:ELAINE
Last Name:JORDAN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 NINE RD
Mailing Address - Street 2:
Mailing Address - City:BRADY
Mailing Address - State:TX
Mailing Address - Zip Code:76825-7210
Mailing Address - Country:US
Mailing Address - Phone:325-456-7117
Mailing Address - Fax:
Practice Address - Street 1:2010 NINE RD
Practice Address - Street 2:
Practice Address - City:BRADY
Practice Address - State:TX
Practice Address - Zip Code:76825-7210
Practice Address - Country:US
Practice Address - Phone:325-456-7117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1119114363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care