Provider Demographics
NPI:1851744874
Name:MILLER, JORDAN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JORDAN
Middle Name:
Last Name:MILLER
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 1:6505 CARDINAL FOREST CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-8482
Mailing Address - Country:US
Mailing Address - Phone:336-688-8980
Mailing Address - Fax:336-629-2205
Practice Address - Street 1:350 N COX ST
Practice Address - Street 2:SUITE 6
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5566
Practice Address - Country:US
Practice Address - Phone:336-629-2201
Practice Address - Fax:336-629-2205
Is Sole Proprietor?:No
Enumeration Date:2016-07-14
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008728363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily