Provider Demographics
NPI:1699400010
Name:JORDAN, SHAYLA (FNP)
Entity Type:Individual
Prefix:
First Name:SHAYLA
Middle Name:
Last Name:JORDAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 WOODLANDS PKWY # 230-161
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77382-2575
Mailing Address - Country:US
Mailing Address - Phone:832-236-7431
Mailing Address - Fax:
Practice Address - Street 1:6886 WOODLANDS PKWY STE C
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77382-2416
Practice Address - Country:US
Practice Address - Phone:281-402-8235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1077039363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily