Provider Demographics
NPI:1821859265
Name:FLIEHS, JORDAN (CNP)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:FLIEHS
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 8TH AVE NW STE A
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-1865
Mailing Address - Country:US
Mailing Address - Phone:605-226-2663
Mailing Address - Fax:
Practice Address - Street 1:701 8TH AVE NW STE A
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-1865
Practice Address - Country:US
Practice Address - Phone:605-226-2663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP003083363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily